BRCAplus


At this time, this test may only be ordered by healthcare providers within the Mount Sinai Health System. For any questions, please contact customer support.



Related Gene(s): ATM, BRCA1, BRCA2, CDH1, CHEK2, PALB2, PTEN, TP53

BRCAplus is a next-generation sequencing (NGS) panel that simultaneously analyzes 8 breast cancer susceptibility genes, all with published management guidelines. Identification of a mutation these genes can help estimate cancer risk and guide treatment, screening, and/or prevention decisions for the patient.

All genes on the BRCAplus panel are evaluated using next-generation sequencing (NGS) or Sanger sequencing of all coding domains, and well into the flanking 5’ and 3’ ends of all the introns and untranslated regions. In addition, sequencing of the promoter region is performed for PTEN (c.-1300 to c.-745). The BRCA2 Portuguese founder mutation, c.156_157insAlu (also known as 384insAlu) is detected by NGS and confirmed by PCR and agarose gel electrophoresis. A secondary sequencing method is performed for any regions with insufficient read depth coverage for reliable heterozygous variant detection. Reportable small insertions and deletions, potentially homozygous variants, variants in regions complicated by pseudogene interference, and single nucleotide variant calls not satisfying 100x depth of coverage and 40% het ratio thresholds are verified by Sanger sequencing. Gene copy number analysis by a targeted microarray identifies gross deletions and duplications in all 6 genes.

Single gene testing and genetic testing for a known familial mutation can also be ordered. If there is a previously-identified mutation in a family member, please include a copy of the test report with the requisition form.


Specimen Requirements

  • Whole blood: Two 4.5 mL EDTA tubes (lavender top)
  • For transfusion patients, please wait at least 2 weeks after a packed cell/platelet transfusion, and at least 4 weeks after a whole blood transfusion prior to blood draw for testing
  • For chemotherapy patients, the DNA quality may be affected if patient has received chemotherapy within the last 120 days. Sema4 may request an additional specimen if DNA quality is insufficient

  • Saliva: 2 mL of freshly-collected saliva in an Oragene container per kit’s specific instructions
  • Fill up to black line with 2 mL of saliva and close the lid. Once the lid is closed, it automatically adds 2 mL of buffer, for a total volume of 4 mL
  • Please note that 2 containers are required for all pediatric saliva testing kits

Saliva and blood are the most common specimen types we receive. For questions regarding other specimen types and requirements for patients with a significant medical history (including allogenic transplant and hematological diseases), please call us at 203-483-3459 to discuss before sample submission.


Ordering Information

Shipping

  • Ship at room temperature

Turnaround Time

  • 7-10 days from receipt of specimen
  • If required by insurance, benefits investigation and pretest genetic counseling may delay test results


Resources

Hereditary Cancer Requisition
Hereditary Cancer Genetic Testing Consent