October is Breast Cancer Awareness Month, but the BRCA1/2 genes also strongly affect ovarian, fallopian tube and peritoneal cancer risk. This article is for the women — and men — who are wondering whether they should ask their doctor about BRCA testing in 2026.
On this page
- Who should consider BRCA testing
- Cost and access in India
- What a positive result means
- Cascade testing for family members
- Who orders the test
Who should consider BRCA testing?
- Personal history of ovarian, fallopian tube or peritoneal cancer at any age.
- Breast cancer diagnosed before age 50.
- Triple-negative breast cancer at any age.
- Male breast cancer.
- Multiple breast or ovarian cancers in close relatives.
- Ashkenazi Jewish ancestry with any of the above.
- Known BRCA-positive relative.
Cost and access in India
BRCA1/2 sequencing in India costs Rs 18,000–35,000 depending on lab and panel (full sequencing vs. founder-mutation panel). HRD (homologous recombination deficiency) testing — important for ovarian cancer PARP inhibitor decisions — costs Rs 35,000–60,000. Several reputable Indian labs (MedGenome, Lilac, GeneTech, Strand) offer these tests. Many tertiary cancer centres include genetic counselling in their oncology service.
What a positive result means
A BRCA1 or BRCA2 mutation significantly raises lifetime risk of breast cancer (up to 70%) and ovarian cancer (up to 40% for BRCA1, 20% for BRCA2). It also affects pancreatic, prostate and melanoma risk. For a patient already diagnosed with cancer, a BRCA result determines eligibility for PARP inhibitor maintenance therapy.
Cascade testing for family members
A positive result in the index patient means parents, siblings, children, and sometimes more distant relatives are eligible for predictive testing. Cascade testing is highly cost-effective and can identify high-risk relatives before any cancer develops — enabling intensive surveillance or risk-reducing surgery.
Who orders the test and where to do it
BRCA testing is typically ordered by a gynaecological oncologist, medical oncologist, or genetic counsellor. Dr. Nishtha can review your personal and family history, order appropriate testing, and arrange genetic counselling. WhatsApp +91 76988 00333.
FAQs
Will my insurance cover BRCA testing?
Coverage varies. Some cancer-care insurance policies cover germline testing if a clear indication is documented (e.g., diagnosed cancer plus family history). Pre-authorisation is required.
What is HRD testing and is it different?
HRD (homologous recombination deficiency) testing assesses whether a tumour has BRCA-like behaviour even if BRCA itself is normal. It guides PARP inhibitor decisions in ovarian cancer.
Are there racial differences in BRCA mutations in India?
Yes — certain mutations are more common in specific Indian populations and ancestral groups. A genetic counsellor can advise on whether targeted panel or full sequencing is appropriate.
What is risk-reducing surgery?
For confirmed BRCA-positive women, bilateral salpingo-oophorectomy (removing both ovaries and tubes) by age 35–40 (BRCA1) or 40–45 (BRCA2) significantly reduces ovarian cancer mortality. Discussion is individualised.
Does BRCA testing affect insurance applications?
Indian law has not yet enacted comprehensive genetic non-discrimination legislation. Discuss potential impact with a genetic counsellor before testing if this concerns you.
Reviewed by Dr. Nishtha Tripathi Patel, MBBS, DGO, DNB, Fellowship Gynaecological Oncology, ESGO-certified. For consultations: WhatsApp +91 76988 00333.