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Inherited cancer risk

Found a BRCA1 or BRCA2 variant? Why to confirm it first, how much it raises cancer risk, the options guidelines describe, and what it means for family.

By the GeneMatrix editorial teamUpdated 6 min read

A woman writing questions in a notebook at a kitchen table, a mug beside her.

In short

A BRCA1 or BRCA2 variant is a risk finding, not a diagnosis. If it came from a consumer test or a test of selected variants, ask your clinician to confirm it with a clinical test first. Then a clinician or genetic counselor can explain your risks, the options guidelines describe, and what it means for your relatives.

On this page
  1. Does a positive BRCA result mean you have cancer?
  2. Why should you confirm the result first?
  3. How much does a BRCA variant raise cancer risk?
  4. What options do guidelines describe?
  5. What does your result mean for your family?
  6. Where can you find support?
  7. Where does an at-home test fit?
  8. What a positive BRCA result can’t tell you
  9. What to do next

Does a positive BRCA result mean you have cancer?

No. BRCA1 and BRCA2 are genes that make proteins that help repair damaged DNA.[1] A harmful variant in one of them raises the risk of several cancers, but it isn’t a diagnosis. It doesn’t mean you have cancer, and it doesn’t mean you will get it.

It does mean you have decisions ahead, and they are best made with good information. The first is making sure the result is right.

Why should you confirm the result first?

Not every positive result is real, especially one from a consumer DNA test or a test of selected variants.

  • Rare variants are easy to get wrong. In 49,908 UK Biobank participants, only 4.2% of the rare harmful BRCA1 and BRCA2 variants reported by SNP chips turned out to be real when the same genes were read in full.[2]
  • Raw data can mislead. One clinical lab found that 40% of the variants people sent from consumer raw DNA data for confirmation were false positives.[3]
  • Labels can differ. Some variants marked “increased risk” in consumer raw data, or by a third-party interpretation service, were classified as benign by clinical labs.[3]

How much does a BRCA variant raise cancer risk?

It depends on the gene and the cancer. These are published estimates for people who carry a harmful variant, beside the risk in the general population.

Published cancer risk estimates for people with a harmful BRCA1 or BRCA2 variant
CancerBRCA1BRCA2General population
Breast (women), by age 8072%[4]69%[4]About 13%, at some point in life[1]
Ovarian, by age 8044%[4]17%[4]About 1.1%, at some point in life[1]
Prostate (men), by age 807% to 26%[1]19% to 61%[1]About 10.6%[1]
Breast (men), by age 700.2% to 1.2%[1]1.8% to 7.1%[1]About 0.1%[1]
Pancreatic, at some point in lifeUp to 5%[1]5% to 10%[1]About 1.7%[1]

Estimates vary between studies. In the study behind the first two rows, breast cancer risk also rose with the number of close relatives who had breast cancer, and differed with where in the gene the variant sat.[4] Your clinician can put these numbers in the context of your own family.

What options do guidelines describe?

The National Cancer Institute (NCI) describes three kinds of option for reducing cancer risk after a harmful BRCA variant: enhanced screening, risk-reducing surgery, and medicines to reduce risk.[1] Which of them, if any, suits you is a decision for you and your clinician.

  • Breast screening. NCI says professional groups generally recommend that women with a harmful BRCA variant start breast screening at younger ages, with breast MRI as well as mammograms.[1] The American Cancer Society’s guideline, for example, describes a breast MRI and a mammogram every year, typically from age 30, for women at high risk, including those with a known BRCA1 or BRCA2 variant.[5]
  • Ovarian cancer. NCI says no effective ovarian cancer screening method is known: the tests available don’t appear to find ovarian tumors early enough to improve long-term survival.[1]
  • Risk-reducing surgery. Removing breast tissue, or the ovaries and fallopian tubes, is one of the options NCI describes. It can’t remove all of the tissue that could become cancer, so it doesn’t guarantee cancer won’t develop.[1]
  • Medicines to reduce risk. Some medicines are approved to reduce breast cancer risk, but NCI says it isn’t yet clear whether they can be used for women whose greatly increased risk comes from an inherited variant.[1]
  • Men. NCI says men with a harmful BRCA variant should discuss screening options with their clinician, and that some guidelines recommend breast and prostate cancer screening for them.[1]

What does your result mean for your family?

BRCA variants are passed down. Each of your children has a 1 in 2 chance of carrying the same variant, and your parents, brothers and sisters are the relatives most likely to share it. Aunts, uncles, nieces, nephews and cousins are also more likely to carry it.[6]

  1. 1Keep your confirmed reportHold on to the clinical report that names your exact variant.
  2. 2Tell close relatives firstParents, brothers, sisters and adult children are the most likely to share it.
  3. 3Share the exact variantGiving relatives the details of your specific variant helps their doctors know which test to use.[6]
  4. 4Let each relative decideEach relative can talk to their own clinician about testing for that one variant. This is called cascade testing.

CDC says that if a variant has been found in the family and a relative’s test shows they don’t have it, they are not at higher risk than the average person for breast or ovarian cancer, and they can’t pass that variant on to their children.[7] That only holds for a test of the exact family variant.

A relative with no known family variant to test for has a different decision to make. Our page on hereditary cancer testing sets out who should consider it and the routes to a test.

A family treeRelatives across three generations drawn as a pedigree, squares and circles joined by lines, as a clinician sketches a family history. No one is marked.
A confirmed variant is shared information: a family tree shows who else may want to talk to their own clinician about testing.

Where can you find support?

News like this can take time to take in. You don’t have to work through it alone:

  • A genetic counselor. The National Society of Genetic Counselors keeps a public directory of counselors in the US and Canada, including ones who meet by phone or video.[8]
  • People who have been there. FORCE, an organization for people and families facing hereditary cancer, offers one-to-one peer support and a helpline.[9]
  • Your own clinician, who can refer you to the specialists you need, when you need them.

A BRCA variant raises risk. It doesn’t decide what happens, and it doesn’t have to be faced alone.

Where does an at-home test fit?

If you already have a positive result, or a relative has a known variant, an at-home test of selected variants isn’t your next step. Your next step is clinician-ordered testing: confirming your own result, or testing for the exact variant known in your family. The same goes for anyone who has had cancer, or whose close relative has: ask your clinician or a genetic counselor about clinician-ordered full-gene testing.

GeneCancer is for people without a personal or family history of cancer who want to know whether they carry any of a set of selected variants. It checks selected variants across 108 genes, including BRCA1 and BRCA2, by genotyping. It doesn’t read those genes in full, so it can miss variants that full-gene testing would find, and a result with no variant found doesn’t rule out inherited risk.

Selected variants only, by genotyping. Not a full-gene test.

What a positive BRCA result can’t tell you

  • Whether you will get cancer. A BRCA variant raises risk. It doesn’t decide the outcome.
  • Which option is right for you. Screening, surgery and medicines each have benefits and harms that depend on your age, health and plans.
  • Anything reliable, until it is confirmed. An unconfirmed result from a consumer test or a test of selected variants may be wrong.[3]
  • Your relatives’ results. Each relative needs their own test for the family variant.

What to do next

Sources

  1. [1]BRCA Gene Changes: Cancer Risk and Genetic Testing (fact sheet, reviewed July 19, 2024). National Cancer Institute. Accessed .
  2. [2]Use of SNP chips to detect rare pathogenic variants: retrospective, population based diagnostic evaluation. BMJ, 2021. Accessed .
  3. [3]False-positive results released by direct-to-consumer genetic tests highlight the importance of clinical confirmation testing for appropriate patient care. Genetics in Medicine, 2018. Accessed .
  4. [4]Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA, 2017. Accessed .
  5. [5]American Cancer Society Recommendations for the Early Detection of Breast Cancer (revised July 23, 2026). American Cancer Society. Accessed .
  6. [6]Talking to Family About Your BRCA Gene Mutation. Centers for Disease Control and Prevention. Accessed .
  7. [7]Genetic Testing for Hereditary Breast and Ovarian Cancer. Centers for Disease Control and Prevention. Accessed .
  8. [8]Find a Genetic Counselor. National Society of Genetic Counselors. Accessed .
  9. [9]FORCE: Facing Our Risk of Cancer Empowered. FORCE. Accessed .

How we write and source these pieces: our editorial policy.

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NoteSelected variants only, by genotyping. Not a full-gene test.

LabOur genetic tests are laboratory-developed tests performed in our own CLIA-certified laboratory. New York is the exception: orders shipped there are completed through a physician order or a reference laboratory permitted in New York. Our genetic tests have not been cleared or approved by the FDA. Results describe inherited traits and risks and are meant to inform decisions you make with your clinician. They are not a diagnosis.