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Molecular Testing for Germline Variants Associated with Ovarian Cancer (BRIP1, RAD51C, RAD51D, NBN)

Testing for germline BRIP1, RAD51C, and RAD51D variants for ovarian cancer risk assessment in adults may be considered medically necessary when the following criteria are met:
The individual has a diagnosis of epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer; AND

The individual has not previously been tested for these gene variants; AND

The individual is thought to be the most informative member of a family (proband) to have genetic testing (see Policy Guidelines); AND

The individual has closely related (first- and/or second-degree) relatives who are considering genetic testing for these gene variants to inform prophylactic decision-making or who have test results that cannot be fully interpreted without testing an affected relative; OR

The individual has not been diagnosed with epithelial ovarian cancer; AND

The individual has any blood relative with a known pathogenic/likely pathogenic germline BRIP1, RAD51C, or RAD51D variant; OR

The individual has a first- or second-degree relative diagnosed with ovarian cancer.a

Testing for germline NBN variants for ovarian cancer risk assessment in adults is considered investigational.

Testing for germline BRIP1, RAD51C, RAD51D, and NBN variants in individuals diagnosed with epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer to guide treatment of the diagnosed individual is considered investigational.

Testing for germline BRIP1, RAD51C, and RAD51D variants for ovarian cancer risk in adults who do not meet the criteria above is considered investigational.

a For familial assessment, first- and second-degree relatives are blood relatives on the same side of the family (maternal or paternal):

First-degree relatives: parents, siblings, and children

Second-degree relatives: grandparents, aunts, uncles, nieces, nephews, grandchildren, and half-siblings.

787-277-6653 787-474-6326