What Is Genetic Testing and Counseling?
Genetic counseling and testing allow experts to gather information based on your family history and genes.
Your genes are present in every cell in your body. They're packaged into structures called chromosomes, made up of DNA and protein molecules. The DNA molecules come in four different subunits, and the order of these subunits is the code that makes up our genes.
Genetic testing gives experts the information they need about changes in chromosomes, genes, and proteins to determine if you're at risk of inheriting a disease.
Some genetic tests look for specific changes in one or more genes. Some look for changes in chromosomes. Other tests look for differences across all of your genes.
What is genetic counseling?
In genetic counseling, a specially trained genetic counselor talks with you about your risk of cancer or other problems.
They go over your health history and your family’s health history. They can help you decide if genetic testing is right for you and interpret the results of genetic tests.
What is genetic testing?
Genetic testing looks for gene mutations that can affect how your body works. These changes in your genes may increase your risk — or your family member's risk — risk for some certain health conditions.
Genetic tests are usually done with samples of blood or saliva. The samples go to a lab for gene mutation testing, and the results are then sent to your doctor.
The information gathered from genetic testing can help you understand the risk of getting certain diseases.
What Conditions Do We Treat?
Several genetic testing labs are located within the Center for Medical Genetics and Genomics. These laboratories provide a range of genetic tests to screen for and diagnose genetic diseases and inherited disorders.
If you’re pregnant, we can check for genetic conditions in your unborn baby.
If you have a personal or family history of the following cancers, you may be a good candidate for genetic testing:
Specific gene mutations — BRCA1 and BRCA2 mutations — increase your risk of developing breast or ovarian cancer. These genes can be passed down from your mother or father.
If you have relatives with cancer-related mutations or just a high number of cancers in your family, your doctor may recommend genetic testing to see if you have genetic mutations linked to cancer.
These tests most commonly screen for mutations in the following:
- BRCA1 gene
- BRCA2 gene
- PALB2 gene
We run blood or saliva tests to screen for mutations in BRCA1, BRCA2, and other genes. Knowing that you have a mutation in one of these genes gives us information about your cancer risk. We can help you develop a prevention plan to reduce your risk of these diseases.
Doctors may also recommend genetic tests to diagnose or monitor blood cancers such as leukemia or lymphoma. The UPMC Cytogenetic Laboratory and the UPMC Clinical Genomics Laboratory perform genetic testing for these health conditions.
Breast cancer and genetic testing
Certain genetic changes, such as a BRCA1 or BRCA2 mutation, increase your risk of developing breast cancer. If your mother or father had one of these gene mutations, they may have passed it on to you. Having a gene mutation may also put you at increased risk for other cancers, such as ovarian or colorectal cancer.
Risk factors for breast cancer include:
- Age — The risk for breast cancer increases with age. Most breast cancers are diagnosed after 50 years of age.
- Alcohol — Drinking can raise your risk for breast cancer.
- Dense breasts — Women with dense breast tissue are more likely to get breast cancer. Dense breasts can also make it hard to see tumors on a mammogram.
- Family history of breast or ovarian cancer — Your risk is higher if several family members had breast cancer or had it at a young age.
- Genetic mutations — Inherited changes in genes, such as BRCA1 and BRCA2, increase the risk of breast cancer.
- History of radiation therapy — If you had radiation therapy before age 30, you have a higher risk of getting breast cancer later in life.
- Hormone therapy — Some forms of hormone therapy during menopause can raise the risk for breast cancer. Certain birth control pills may also raise breast cancer risk.
- Menstrual history — Starting your periods before 12 or menopause after 55 exposes you to hormones longer, which raises the risk of breast cancer.
- Obesity — Being overweight increases your chance of getting breast cancer.
- Previous history of breast cancer — If you’ve had breast cancer once, you’re more likely to get it again.
- Reproductive history — Having a first pregnancy after 30, not breastfeeding, or never having a full-term pregnancy can raise breast cancer risk.
- Sedentary lifestyle — Women who are not physically active have a higher risk of getting breast cancer.
- Smoking — Tobacco use raises your risk of many kinds of cancer, including breast cancer.
Ovarian cancer and genetic testing
Researchers have identified certain genes that, when mutated, increase your risk for ovarian cancer. If you have a strong family history of breast or ovarian cancer, you should consider genetic testing.
Women with mutations in certain genes, such as BRCA1 or BRCA2, are more likely to develop ovarian cancer.
UPMC offers high-risk ovarian cancer services that help women learn about and manage their risk of getting ovarian cancer. Genetic test results can also help you make more informed medical decisions in the future.
Can genetic testing diagnose ovarian cancer?
Genetic testing can’t diagnose ovarian cancer. But it can detect genetic risk factors that make you more likely to develop the disease. Our specialized monitoring can then help catch ovarian cancer early, when it’s easier to treat.
Genetic testing for ovarian cancer is important because there’s no universal screening test for ovarian cancer.
Risk factors for ovarian cancer include:
- Age — Most cases of ovarian cancer occur in women over 55.
- Ethnic background — Women of Eastern European or Ashkenazi Jewish heritage have a higher risk of ovarian cancer.
- Family history — Your risk of ovarian cancer is higher if a close family member on either side of your family had it. That includes your mother, sisters, aunts, or grandmothers. If more than one family member had ovarian cancer, your risk may be even higher.
- Genes — Having a mutation in either the BRCA1 or BRCA2 genes raises your risk of ovarian cancer. There are also many other gene mutations that can increase the risk for ovarian cancer. For example, having a mutation in one of the Lynch syndrome genes (MLH1, MSH2, MSH6, PMS2, or EPCAM) increases the risk for ovarian, colorectal, uterine, and other cancers.
- History of endometriosis — In endometriosis, tissue from the lining of the uterus grows into other parts of the body. A history of endometriosis raises your risk of ovarian cancer.
- Hormone therapy — This common treatment for menopause may slightly increase the risk of ovarian cancer.
- Menstrual history — Starting your menstrual cycle before age 12 or reaching menopause after age 52 raises your risk of getting ovarian cancer.
- Never giving birth — Not having any pregnancies is a risk factor for ovarian cancer.
- Obesity— Being overweight can increase your risk for many cancers, including ovarian cancer.
- Radiation to the pelvis — Getting radiation for another type of cancer may increase your chance of getting ovarian cancer.
- Smoking — Smoking increases your risk of most cancers, including ovarian cancer.
Pregnancy-related genetic testing
Your doctor may recommend genetic testing if someone in your family — or your partner's — has a genetic disease or inherited disorder and you're pregnant or thinking about getting pregnant.
Specialists at UPMC offer a range of genetic testing before pregnancy (preconception) and during pregnancy (prenatal testing). Genetic counselors talk with you and your partner about further testing and options when screening tests indicate an increased risk of genetic disorders.
Genetic carrier screening
Genetic carrier screenings tell doctors if you or your partner have a copy of a gene mutation. When both parents have a copy of certain gene mutations, their baby may have a genetic disorder.
Carrier screening is usually done before getting pregnant, but it can provide helpful information after, as well.
Prenatal genetic testing
Pregnancy genetic testing may be right for you if you:
- Are 35 or older.
- Belong to an ethnic group with a higher risk of some health conditions or diseases.
- Have an inherited condition or congenital disability.
- Have another child diagnosed with an inherited disorder or congenital disability.
- Have a risk factor related to your health history, job, or lifestyle that could lead to a congenital disability.
Genetic testing during pregnancy helps specialists identify genetic mutations in the fetus before birth.
Genetic testing can help doctors diagnose:
Who Can Benefit from Genetic Counseling and Testing?
Not everyone needs genetic testing. Some gene mutations pass from parent to child. If someone in your family has a genetic mutation, you are more likely to have the same mutation.
Other changes to genes happen spontaneously (on their own). If this happens, you may be the only person in your family with a specific gene mutation.
Having a gene mutation means you may be at greater risk for a genetic disorder or health condition. Genetic testing can tell you if you have the mutation. A genetic counselor can discuss what it means for your risk of disease.
Your doctor may recommend genetic testing to learn how your unique mutations affect your risk for inherited disorders. Genetic tests can also help you understand your risk for some cancers.
These tests may also help doctors understand why you may have:
You may also have genetic testing while you are pregnant. Genetic screening of the fetus can identify potential health issues in your baby.
Mutations could cause:
- Congenital disabilities.
- Higher risk for certain diseases.
- Intellectual differences.
Understanding your unique gene mutations with genetic testing can teach you about your health, pregnancy, or your baby's health.
Genetic testing and counseling can help you:
- Understand your health risks.
- Explore treatment options after diagnosis of a genetic condition.
- Plan for your future.
What Genetic Counseling and Testing Do We Offer for Breast and Ovarian Cancer?
At UPMC, we offer a range of genetic testing options. We can recommend what’s right for you based on your medical history and family history.
Our approach includes education, testing, counseling, and preventive care.
Education and personalized surveillance plan
- Find out if family members, including your children, are at increased risk of getting ovarian or breast cancer.
- Learn about your own ovarian or breast cancer risk factors.
- Set up a plan to monitor your health, including regular doctor visits and testing.
Genetic counseling and testing
- Learn if you have an increased likelihood of getting breast or ovarian cancer.
- Make informed medical decisions for your future.
- Test for mutations in the BRCA1 and BRCA2 genes, as well as other genes associated with increased breast and ovarian cancer risk. These tests use a blood or saliva sample, taken in a doctor’s office or laboratory.
Prevention strategies
- Maintain a healthy weight.
- Make healthy lifestyle choices.
- Quit smoking.
- Schedule regular pelvic exams and mammograms.
Research studies
- Find out if you are eligible for new or ongoing UPMC ovarian and breast cancer research studies.
- Participate in breast and ovarian cancer research aimed at improving early detection, diagnosis, treatment, and prevention.
- Take advantage of the most recent treatment options available.
Risk assessment and screening
- CT scans.
- MRIs.
- Regular physical exams.
- Specific blood tests that measure proteins sometimes elevated in ovarian cancer.
- Ultrasound.
What Genetic Tests Do We Offer for Pregnancy-Related Issues?
Your doctor considers your personal and family health history when recommending genetic testing. If they suspect you or your baby has a specific genetic disorder, they consider the genetic mutations associated with it. Then, they recommend the genetic test that will provide the information they need to make a diagnosis.
Types of genetic tests include:
Biochemical genetic testing
Specialists examine your body's proteins and how they function. Tests that show changes in proteins or their function may indicate mutations in the DNA, which can cause genetic disorders.
Experts may analyze a sample of your:
Chromosomal (cytogenetic) testing
Experts analyze chromosomes to determine if they've undergone any structural changes.
Chromosomal changes may include:
- An extra copy of a chromosome.
- A missing copy of a chromosome.
- Changes in the arrangement of chromosomes or their parts.
- Duplication of part of a chromosome.
Chromosomal tests can identify specific mutations in chromosomes.
Specialists may collect a chromosome sample through:
- Amniocentesis — Specialists use a needle to remove some of the amniotic fluid that surrounds the fetus in the uterus. They examine this sample for changes that may indicate a genetic disorder.
- Blood test — Providers draw blood from a vein with a needle. Specialists examine the blood to look for genetic changes.
- Bone marrow aspiration — Specialists insert a thin needle into a bone and remove a small sample of bone marrow. They examine cells in the bone marrow to find genetic changes.
- Chorionic villus sampling — Specialists use a thin tube (catheter) to remove a small amount of tissue from the placenta. They use this tissue to diagnose chromosome disorders and other genetic conditions in an unborn baby.
Molecular genetic testing
Specialists use molecular testing to determine if there is a single variant (changes in one specific gene) or a gene panel (changes in several genes).
They may collect a sample of your:
- Amniotic fluid (through an amniocentesis).
- Blood.
If you are pregnant, some of your baby's DNA circulates in your blood, known as prenatal cell-free DNA. Experts analyze prenatal cell-free DNA to learn if your baby may have a genetic disorder. This is called noninvasive prenatal testing.
Whole genome sequencing
Sometimes, doctors recommend whole genome sequencing, also called whole exome sequencing. These tests analyze all the genes in your body. Your doctor may recommend whole genome sequencing when other types of genetic testing don't provide enough information.
What Can I Expect?
You’ll have a genetic counseling visit before doctors order any testing. In general, here are a few things you to expect.
Preparing for your visit
- Call your insurance provider to find out if they will cover the cost of genetic counseling and testing.
- Gather any relevant family medical history. Get as much specific information as possible about instances of cancer in your family.
- Provide medical records if we won’t have access to them.
During the counseling appointment
The first appointment will consist of meeting with a genetic counselor. It’s not a medical exam.
You will meet with a genetic counselor for about an hour. They will review your personal health and family history.
They may discuss:
- Basic information on inheritance and the possible role of genes in your risk of cancer or pregnancy issues.
- Cancer screening options.
- Risks, benefits, limitations, and costs of genetic testing.
- How genetic test results might affect you and your family.
- Potential research studies.
- Risks, benefits, limitations, and costs of genetic testing.
- The types of genetic tests available.
- When appropriate, your estimated risks risk for certain cancers based on your age, family history, and other factors.
Your genetic counselor may also provide information about services and specialists, including:
- Cancer screening.
- Nutrition experts.
- Social workers.
- Specialists in cancer risk management.
- Surgery consultation.
What does genetic testing cost?
Talk to your doctor about genetic testing. You may need more than one type of genetic test. Alternatively, several family members may need genetic tests to get the information your doctor needs.
Costs for genetic testing vary by the type of test and your insurance coverage. Your doctor or genetic counselor can provide cost information for the specific genetic tests they recommend. Generally, depending on the complexity of the genetic test, costs may range from $100 to several thousand dollars.
Your health insurance policy may cover some types of genetic testing. Talk to your insurance provider to learn about coverage for the tests your doctor recommends.
What do genetic testing results mean?
Genetic testing can provide valuable information. Some tests can tell you only if you are at increased risk for a disease or for problems during pregnancy. An increased risk for a health condition means only that it may occur.
Some genetic tests diagnose health conditions. Before having genetic testing, it's important to consider what you will do if test results indicate a genetic disorder — especially in an unborn fetus. Talking with a genetic counselor can help you decide if you want to know this information.
Should I have genetic testing?
Genetic testing has many benefits. You may decide to make different health decisions if you have a gene mutation that may increase your risk of developing cancer.
If you have a mutation that increases your risk of a certain cancer, you may:
- Be on the lookout for cancer symptoms.
- Have more, or more frequent, screenings for that cancer.
- Make lifestyle changes to protect your health.
- Take medication or have surgery to reduce your cancer risk.
If you're pregnant or thinking about becoming pregnant, genetic testing can help you understand your risk factors for:
- Problems during your pregnancy.
- Your baby having a genetic disorder or inherited disorder.
If you have a risk of having a child with an inherited disorder, you can look into IVF and embryo screening as an option for conception.
Contact Us
Talk to your doctor about whether genetic testing is right for you. UPMC's genetic testing lab is here to help.
- To learn more about laboratory services at the Center for Medical Genetics and Genomics, call 412-641-4168 (option 2).
- Learn more about prenatal genetic testing and counseling at UPMC Magee-Womens in Central Pa. or call 717-231-8472.
By UPMC Editorial Staff. Last reviewed on 2024-09-05.