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Purpose  The National Comprehensive Cancer Network (NCCN) has proposed guidelines for the genetic testing of the  BRCA1  and  BRCA2  genes, based on studies in western populations. This current study assessed potential predictive factors for  BRCA  mutation probability, in an Asian population.    Methods  A total of 359 breast cancer patients, who presented with either a family history (FH) of breast and/or ovarian cancer or early onset breast cancer, were accrued at the National Cancer Center Singapore (NCCS). The relationships between clinico-pathological features and mutational status were calculated using the Chi-squared test and binary logistic regression analysis.    Results  Of 359 patients, 45 (12.5%) had deleterious or damaging missense mutations in  BRCA1  and/or  BRCA2 .  BRCA1  mutations were more likely to be found in ER-negative than ER-positive breast cancer patients ( P =0.01). Moreover, ER-negative patients with  BRCA  mutations were diagnosed at an earlier age (40 vs. 48 years,  P =0.008). Similarly, triple-negative breast cancer (TNBC) patients were more likely to have  BRCA1  mutations ( P =0.001) and that these patients were diagnosed at a relatively younger age than non-TNBC patients (38 vs. 46 years,  P =0.028). Our analysis has confirmed that ER-negative status, TNBC status and a FH of hereditary breast and ovarian cancer (HBOC) are strong factors predicting the likelihood of having  BRCA  mutations.    Conclusions  Our study provides evidence that TNBC or ER-negative patients may benefit from  BRCA  genetic testing, particularly younger patients (<40 years) or those with a strong FH of HBOC, in Asian patients.

Predictive Factors for BRCA1 and BRCA2 Genetic Testing in an Asian Clinic-Based Population