When you hear that your mother had breast cancer, or that your aunt and grandmother suffered from the same disease too, your heart sinks. At times like that, one thing that comes to mind is BRCA genetic testing. The name became familiar after the news that Angelina Jolie had preventive surgery based on this test result, but when it actually comes to "should I get it too," it is hard to know where to even start looking.
BRCA1 and BRCA2 are originally genes whose role in our body is to repair damaged cells and suppress cancer. If you are born with a mutation in one of these, the risk of developing breast or ovarian cancer rises considerably above average. In fact, inheriting a mutation absolutely does not mean you will get cancer 100 percent. The risk simply goes up, and many people go through their whole lives without anything happening. It is just a signal that you need to keep watch earlier and more closely than usual.
So, if you have a family history, do you absolutely have to get tested? Not necessarily. What is usually recommended is when you have a relative who was diagnosed with breast cancer at a relatively young age, when cancer appeared in both breasts rather than just one, when breast and ovarian cancer appeared together in one person or one family, and, rarely, when there is male breast cancer in the family. If it is just a more distant relative who developed it in old age, the risk may not be all that high. That is why, rather than rushing into testing, it is recommended to lay out the family tree and get genetic counseling first.
The test itself is simpler than you might think. You just have your blood drawn or swab the inside of your mouth with a cotton swab and send it off. The difficult part is not the test but what comes after you receive the result. If a mutation shows up, you discuss moving your screening schedule earlier, adding an MRI, and, for some people, even medication or preventive surgery. Conversely, sometimes you get an ambiguous result called a "variant of uncertain significance," which means the risk cannot be determined for sure, and interpreting it alone tends to make you more anxious for nothing. That is why it is really important to have an expert beside you who can work through with you how to take the result and plan the next step.
One more thing I want to point out is the matter of the heart. A negative result is reassuring, but if it comes back positive, the thought "someday it will be me too" can weigh on you for a while. You also agonize over whether to tell your family. So before you receive the result, it helps to picture in advance what you can do next, whatever answer comes. When you think of the test not as an ending but as the starting point of management, your heart feels a little lighter.
To sum up, not everyone with a family history needs to be tested, but if you fall under the characteristics mentioned above, it is well worth getting counseling once. In the end, the key is not "whether you get tested" but "whether you know your risk and take care of it in advance." Knowing accurately and preparing is far more reassuring than living with vague anxiety. That said, what is written here is general talk, so please decide whether testing is right in your case by discussing directly with a doctor who has looked into your family history.