Telling family members about a positive test result
If your test shows that you have a BRCA1 or BRCA2 gene variant ('variant present') it's possible that your relatives will also have a BRCA1 or BRCA2 variant.
Adult members of your family can choose to have a genetic test to find out if they have inherited the same gene variant. This is called predictive testing because a positive result ('variant present') for them means they have an increased risk of developing cancer. It doesn't mean they have cancer or are definitely going to develop it.
The variant in your BRCA1 or BRCA2 gene is likely to have been inherited from your mother or father. If they're unaware of their BRCA1 or BRCA2 status, they can access advice about testing, as can their siblings, nieces and nephews (your aunts, uncles and cousins).
Anyone who inherits a BRCA1 or BRCA2 variant, whether or not they develop cancer themselves, may pass the variant on to their children.
Not everyone with a BRCA1 or BRCA2 variant will develop cancer.
- What does this mean for my siblings?
Your full siblings (with the same mother and father) will have a 50 per cent (one in two) chance of also carrying the BRCA1 or BRCA2 gene variant and will be able to access predictive testing. The chance for half-siblings may be less than 50 per cent depending on family history, but they can still ask for predictive testing.
- What does this mean for my children?
Your children will also have a 50 per cent (one in two) chance of inheriting the BRCA1 or BRCA2 gene variant. Testing is only available to adults over the age of 18 because the risk management options are either not available or not yet necessary for those under 18. It's important that they make their own informed choice about whether or not to be tested.
How do I tell my family and how might they feel?
If your relatives are aware that you're having genetic testing, a conversation about the results may happen naturally. Depending on how you're feeling (physically and emotionally) it can feel like a difficult discussion to have. It can be particularly challenging if there are young family members you want to share the information with. You may struggle with the thought of maybe passing on a gene variant to your children.
All these feelings are completely normal so please remember you're not alone. You may find that talking to your partner, if you have one, or a friend can be helpful. Your local clinical genetics service is also available to provide support.
You may find that your relatives are wondering whether they have an increased cancer risk and are very accepting of the news about a gene variant. It means they're able to have a predictive genetic test and can take action if they're at increased risk.
Many people choose to have predictive genetic testing because they would rather be aware of an increased risk of cancer and manage or reduce the risk by having regular tests or even surgery (a risk-reducing operation). But knowing about a possible increased cancer risk may cause anxiety for relatives. Some people are concerned about the possible impact on their work and insurance. There's more information about this in our Genetic testing guide [PDF].
Some people are worried about the impact a possible increased cancer risk might have on future relationships and having children of their own. Help and support is available, including from your local clinical genetics service.
You may find you have relatives who are resistant to genetic testing and who would rather not receive the information. You may have relatives that you’re not in contact with. Your local clinical genetics service will be able to discuss this with you. If you think it will be helpful, they can provide an 'open letter' that you can send to relatives that explains about the gene variant and the genetic testing available to them.
Whether and when your relatives decide to have predictive genetic testing is up to them. Everyone's different and some adjust to the news quicker than others. You'll have given them an option that may not otherwise have been available to them.
