For genetic testing, an affected family member should be first tested for the presence or absence of a specific mutation. If no mutation is found in the affected member, there is no need to offer genetic testing to these unaffected family members, since the test results will not be informative. If a mutation is detected in an affected individual, then it is advisable to test the close unaffected family members for the presence or absence of the same mutation. If no mutation is found, the unaffected relative's risk is not increased due to the genes carried by the affected relative. Although the chances are less than those of the mutation carriers, these unaffected relatives can still develop breast cancer later in life.
Genetic testing is expensive and subject to controversy.
Issues surrounding genetic testing involves discrimination in terms of insurability, as well as employability. Legislation is definitely needed to protect high-risk individuals from both insurance and employer discrimination based on the genetic information. Genetic testing should be considered only if the results significantly change the decision of a high risk individual as far as prophylactic interventions are concerned. Proper measures should also be taken to assure that the high-risk individual understands the uncertain nature of the predicted risks as well as the associated consequences. Psychosocial factors and personal beliefs about causes and prognosis of the illness must also be taken into account to provide relevant information to the patient that is understood.