Background: BRCA 1/2 genes have a critical role in DNA repair and genome stability. BRCA mutations are responsible for the majority of hereditary breast and ovarian cancer (HBOC) syndromes, and BRCA mutations increase susceptibility to several cancers, including male breast cancer, ovarian, prostate, pancreatic, and possibly glioblastoma and melanoma. BRCA2 mutations are responsible for about 5% to 10% of all breast cancers. With a growing number of laboratories offering BRCA testing and as clinicians move toward multigene panels for testing, we sought to assess the baseline use of BRCA testing in the VHA.
Methods: Data identifying veterans who underwent BRCA testing were obtained from Ambry, GeneDX, Myriad, and Quest. We merged these data with the VA corporate data warehouse to identify patient and site of characteristics associated with testing.
Results: There were 868 veterans who underwent BRCA testing from January 2012 until December 2013. Of those tested, 141 were male and 727 were female veterans. The age of men tested ranged from 24 years to 80 years; the mean was 62 years. The age of women tested ranged from 21 years to 77 years; the mean was 46 years. Credentials of clinicians ordering the tests included advanced practice nurses (8%), physicians (87%), physician assistants (2%), and genetic counselors (3%). Veterans were tested in 46 of the 52 states. However, the number of veterans per state ranged from a high in California of 43 to just 1 veteran tested in many states. Ongoing analysis is examining clinical characteristics and diagnosis codes of veterans tested to identify whether testing was concordant with guidelines.
