Should Women Take the BRACAnalysis Test?

In previous articles, we discussed cancer testing companies such as Raindance Technologies and Sysmex Inostics that can help identify cancer at the earliest stages in order to allow for early treatment. Other companies like Foundation Medicine can interrogate the entire coding sequence of 236 cancer-related genes which will allow a physician to create personalized cancer treatments for a patient. But what about tests that can predict your risk of hereditary cancer by looking at your genetic makeup for particular mutations? One such test that has been offered for some time now is the BRACAnalysis test offered by Myriad Genetics (NASDAQ:MYGN).

About the BRACAnalysis

Hereditary Breast and Ovarian Cancer (HBOC) Syndrome causes about 10% of breast and ovarian cancer. HBOC is most often caused by a mutation, or alteration, in either of 2 genes: BRCA1 and BRCA2. Why should you care? Well if you have either of these hereditary gene mutations, the likelihood of getting cancer increases significantly as seen below:

BRCA_Chart

The idea is that if you test positive for HBOC syndrome, you can then seek preventative medical care in order to help reduce the likelihood of getting cancer. So how does the test work? Well firstly, you need to go to the doctor as the test can only be ordered by a healthcare professional. If your doctor thinks you should be tested, they will draw a small amount of your blood and send it to Myriad Genetic Laboratories for analysis. Test results will be available as early as two weeks from the date your test is started. The test costs around $3,000 with more than 90% of tests receiving health insurance coverage, and the average reimbursement being more than 90%. The BRACAnalysis does not tell you if you currently have cancer or whether you will develop cancer. The test will simply tell you about your inherited risk of breast and ovarian cancer.

Should Women take the BRACAnalysis Test? 

For the sake of this example, let’s take a population of 10,000 females. There is a 7% chance that any one of these females could develop breast cancer by age 70. This means that all things being equal, 700 of these women will come down with breast cancer before the age of 70. Now as the article mentions, only 10% of these women with breast cancer will also have “Hereditary Breast and Ovarian Cancer (HBOC) Syndrome”. This means that if all 10,000 women in this population took the BRACAnalysis test, only 70 would have been able to take early action. So if a random woman took the BRACAnalysis, there is a .70% chance that the results of the test would be actionable.

It seems that unless you have a known family history of breast or ovarian cancer, there is little purpose for taking the test, especially at a $3000 price point. The 9-question quiz on the BRACAnalysis website can help you determine if you should take the test by asking you questions about the past history of cancer among your “family members”. Will most people have such detailed information about their family history to believe they shouldn’t have to take the test or will they be “not completely sure” and take the test just for the peace of mind? It would be interesting to know the percentage of total tests taken that actually identify hereditary risk.

Myriad Genetics

Myriad Genetics (NASDAQ:MYGN) is the company behind making the BRACAnalysis test a remarkable commercial success. Myriad is a $2.5 billion dollar molecular diagnostics company which has been profitable for the past 5 years. The company realized net income of $176 million in fiscal 2014 on total revenues of nearly $750 million. BRACAnalysis makes up a large but shrinking portion of Myriad’s total revenues as it is now generating over half a billion dollars:

Revenue (in millions) % of Total Revenues
2011 352 88%
2012 405 82%
2013 460 75%
2014 518 67%

At around $3,000 a pop that’s over 172,000 tests administered in fiscal 2014.

Myriad Genetics is a profitable company with a decreasing dependence on the BRACAnalysis as their sole source of revenue which is assuring to investors. In a future article, we’ll take a closer look at the other tests offered by Myriad Genetics which all seem to be showing promising growth.

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