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, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, MRE11A, MUTYH, NBN, NF1, PALB2, PTEN, RAD50, RAD51C, RAD51D, TP53

BreastNext is designed for use in high-risk breast cancer patients, such as those with early-onset or multiple diagnoses of breast cancer, male breast cancer, and/or with a family history of disease. This 17-gene panel offers more precision to identify and manage hereditary breast cancer. These genes can be linked to an increased lifetime risk for one or more cancers, including breast cancer, ovarian cancer, and uterine cancer.

All genes on the BreastNext 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. Clinically significant intronic findings beyond 5 base pairs are always reported. Intronic variants of unknown or unlikely clinical significance are not reported beyond 5 base pairs from the splice junction. Additional Sanger sequencing is performed for any regions missing or 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. Gross deletion/duplication analysis for the covered exons and untranslated regions of all 17 genes is performed using read-depth from NGS data with confirmatory multiplex ligation-dependent probe amplification (MLPA) and/or targeted chromosomal microarray.

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


  • Ship at room temperature

Turnaround Time

  • 14-21 days from receipt of specimen
  • If required by insurance, benefits investigation and pretest genetic counseling may delay test results


Hereditary Cancer Requisition
Hereditary Cancer Genetic Testing Consent