"When the results of a test wouldnt change how doctors manage a patients care most say its not worth doing. But new tests for breast cancer risk mutations beyond the wellknown BRCA genes would offer actionable information for many women and their doctors a new study finds.  The BRCA and BRCA gene mutations put women at high risk for breast ovarian and other cancers but mutations of other genes are believed to confer extra risk as well.  Earlier this year  genetic experts argued against testing for a wider panel of breast cancerrelated gene mutations until they are proven to be valid and useful in clinical practice see Reuters story of May   here reut.rsTvOoDf httpreut.rsTvOoDf.  Theres a lot of controversy even among experts said the senior author of the new study Dr. Leif W. Ellisen of Massachusetts General Hospital Cancer Center in Boston.  For  years atrisk women have only been tested for BRCA and  but many companies now offer multigene panels for   or  other genes Ellisen told Reuters Health.  Are patients better off getting these much broader tests he said. Does it actually change what you would tell them to do in terms of screening prevention or risk management  According to the new results at least for some women it would change their clinical management he said.  Several of the authors of the new paper disclosed that they receive research funding consult for or are employed by genetic testing companies like Myriad Genetics and Invitae Corporation.  Between  and  the study team did panel tests for  or  genes on  women who were referred for hereditary breast or ovarian cancer gene testing but had tested negative for BRCA mutations. Most of the women had a personal history of breast or ovarian cancer already.  The researchers found that  women or  percent of the total group did have potentially harmful mutations in other genes. Of those  women  had mutations carrying low to moderate risk of breast or ovarian cancer eight had mutations associated with Lynch syndrome which increases colon and ovarian cancer risk and three had highrisk breast cancer genes.  Including another  patients who were referred into the study at a late stage there were  women positive for nonBRCA mutations. Of those the researchers decided that  would have been considered for additional screening or prevention measures based on their results. And for many family testing would be recommended for firstdegree relatives according to the report in JAMA Oncology.  Even among all appropriate candidates who are sent for genetic testing only nine percent will test positive for the BRCA mutations so an additional four percent who have nonBRCA mutations is a significant number Ellisen said.  Often these additional women do not have a high risk of breast or ovarian cancer but some do have a high risk of colon or uterine cancer and would be referred for additional screening he said.  Multigene testing is not more expensive than testing for the BRCA mutations alone he said.  Though these results indicate that additional genetic screening is clinically useful some genetic test results will be uncertain and it can be psychologically difficult for patients to deal with this uncertainty Ellisen said.  We do not advocate for broad populationbased screening he said. The interpretation of these tests is not a simple colorbynumbers thing. The vast majority of uncertain genes will be benign but a misinterpretation could lead a patient to a drastic unnecessary surgical procedure he said.  Many cancer genetics experts have again urged caution characterizing the use of multigene testing in the clinical setting as premature Dr. Elizabeth M. Swisher of the University of Washington Medical Center in Seattle writes in a commentary accompanying the new paper.  Yet thousands of women and their physicians are ignoring this advice ordering a wide selection of multiplex tests daily Swisher writes. The train has left the station and is unlikely to return so it is important to assess how useful this additional testing can be she concludes.  SOURCE bit.lyLeE httpbit.lyLeE and bit.lyLpLj httpbit.lyLpLj JAMA Oncology online August  ."