This At-Home Test for Breast Cancer Gene Mutations Is Causing a Peculiar ControversyElizabeth Nelson
23AndMe is a company that offers at-home DNA testing with the goal of giving its clients more information surrounding their genetic makeup and ethnic origin. It’s a relatively inexpensive test and can tell people a lot about their families’ origins.
In 2013, it also developed the capability of informing users about their risk levels for certain diseases without any sort of permission from a doctor. However, the FDA put the kibosh on that endeavor, fearing that people would run to their doctors for unnecessary medical procedures without receiving or paying much attention to proper medical advice first.
However, the FDA changed its tune in 2018. 23AndMe is now allowed to offer its clients information about their risk for breast cancer, as well as other diseases, such as Parkinson’s, Alzheimer’s, and Bloom syndrome.
It’s certainly understandable that people want to know as much as possible about their risk of breast cancer and other diseases, and there’s nothing wrong with offering a service that aims to tell people as much as possible about those risk levels. The test can alert people to three gene mutations that increase the risk of breast cancer, which, for some women, could be useful in determining what choices to make regarding future cancer screening and testing. However, the test poses some significant issues as well.
Because the test is done at home, there’s no way to require medical counseling to help people truly understand their results. This was the FDA’s initial concern about it. Women who are identified as having a higher risk of breast cancer may be frightened into having extra testing or mastectomies that they don’t need. On the other hand, it could lull women who are identified as low-risk into a false sense of security, possibly causing them to neglect monthly self-exams and yearly mammograms.
Secondly, the 23AndMe test only identifies three cancer-associated gene mutations, out of probably thousands that exist, and they aren’t even the three most common mutations. In fact, the information shared about these particular gene mutations is likely to only be helpful to certain small subsections of the population, such as Ashkenazi Jewish women.
The reality is that this test is not a true or accurate measure of most people’s real risk of developing breast cancer. It may be helpful for some, but it should be taken with a few grains of salt. Or, at least, taken to your doctor for another opinion.
If you’re interested in taking the 23AndMe genetic test, or if you’ve already taken it, you should seek professional medical advice about any concerns you have after the test. Never make a medical decision from an at-home genetic test without real medical counseling.