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The coming together of LifeLabs, BC Biomedical and CML HealthCare.
LifeLabs is Canada’s largest community laboratory testing services provider.
LifeLabs Genetics is offering genetic counselling for individuals wishing to pay for BRCA1 and BRCA2 (BRCA1/2) genetic testing in Ontario & B.C. LifeLabs Genetics plans to offer this service for all Canadians in 2018.
Please note that BRCA1/2 genetic testing must be ordered by a physician. To order, an individual obtains a signed requisition from her/his physician, reads the Patient Information sheet, and signs the consent to ensure s/he understands the benefits and risks of testing. Blood can be drawn at any LifeLabs location, where individuals can pay for the BRCA1/2 test and counselling service. Patients wanting more flexibility can request a saliva kit to do a self-collection at home or can arrange a mobile collection for an additional fee. Once the sample is received at LifeLabs Genetics, we will schedule a 15-30 minute genetic counselling telephone information session. A summary of the session will be sent to the ordering physician and the patient. Samples are analyzed by our German laboratory partner, Centogene, and take 4-6 weeks. A copy of the result with an explanatory letter will be sent to the ordering physician and, if this has been authorized on the requisition by the physician. Individuals tested are strongly encouraged to proceed with their post-test genetic counselling prior to receiving the test result via password protected and encrypted email.
Analysis of BRCA1 and BRCA2 genes (BRCA1/2) involves a step by step look through the DNA of each gene for changes, known as mutations. BRCA1/2 genetic testing is most commonly performed on blood but can also be performed on saliva, tissue or banked DNA.
Harmful mutations within the BRCA1/2 genes lead to an increased chance for that individual to develop certain cancers, such as breast, ovarian, fallopian tube, peritoneal, melanoma, pancreas and/or prostate cancer. Individuals with BRCA 1/2 mutations are more likely to develop cancer at a younger age and have more aggressive tumours. Among those who develop cancer, variable age of onset and type of cancer is observed, even within the same family.
It is estimated that 1/400 to 1/800 individuals carry a BRCA1/2 mutation. Certain individuals who are considered to be at a higher risk of having a BRCA1/2 mutation include those with:
If an individual has a personal and family history of any of the above, provincial Ministry of Health funding in Canada for genetic testing for BRCA1/2 and counselling may be available. A physician may consider referring a patient to a local cancer genetics clinic, which can be found through https://www.cagc-accg.ca. Wait times vary per clinic, and can range from 2 months to 2 years.
Some individuals who do not meet the above criteria may still wish to pursue BRCA1/2 genetic testing to find out more information about their risk for cancer, even though the chance of finding a BRCA1/2 mutation is expected to be low.
The information from genetic testing can be used to guide surveillance, prevention and medical management decisions for an individual in regards to cancer. This information can also affect family members.
It is important that prior to receiving a genetic test result, an individual receives genetic counselling to understand the risks and limitations of genetic testing. Genetic counselling provides information regarding the implications of BRCA1/2 genetic testing, cancers associated with these genes, pattern of inheritance and impact for family members. Genetic testing might have a negative impact when applying for insurance, although it is unclear what effect there is on insurance premiums. The result of genetic testing can create emotional burdens (feeling guilty, sad, worried, angry), which can impact individuals and family members and this is discussed during the counselling sessions. During pre-test counselling, the genetic counsellor will:
During post-test counselling the counsellor will review the result and discuss the implications for both the individual and the family.
The result of BRCA1/2 testing will state one of the following:
BRCA1/2 genetic testing is most commonly performed on blood but can also be performed on saliva, tissue or banked DNA.
Results will be available within 4-6 weeks once the lab receives the sample. * Urgent analysis (7-14 business days) is available for an additional fee ($250).
It is estimated that 1 in 300 to 1 in 500 individuals, meaning as many as 117,000 Canadians, carry a BRCA1 or BRCA2 mutation.
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