Cancer genetics - hereditary risk
BrRCo PanelBreast, colorectal and beyond
When family history spans more than one cancer type, or when a 2-gene panel isn’t enough, the BrRCo panel screens 36 genes linked to hereditary breast, colorectal, ovarian, and prostate cancers, in a single test.
Overview
What this test is
Some families carry cancer risk that goes beyond BRCA1 and BRCA2. When the picture is more complex – multiple cancer types, unclear family history, or a prior negative BRCA result – a broader panel gives a more complete answer.
The BrRCo panel analyses 36 genes implicated in hereditary breast, colorectal, ovarian, and prostate cancers, including full coverage of mismatch repair (MMR) genes linked to Lynch syndrome and homologous recombination repair (HRR) genes. It can be performed on blood, saliva, or tumour tissue, making it applicable across both pre-diagnostic risk assessment and active oncology management.
36
genes screened in a single test
4
cancer types covered – breast, colorectal, ovarian, prostate
MMR
mismatch repair genes – key to Lynch syndrome diagnosis
HRR
homologous recombination repair – relevant for PARP inhibitor eligibility
Gene coverage
What the panel screens
The 36 genes span four cancer types and two major DNA repair pathways. Key genes by cancer category include:
Breast cancer
BRCA1, BRCA2, PALB2, CHEK2, ATM, RAD51C, RAD51D, BARD1
Includes all major HRR pathway genes relevant to hereditary breast cancer risk and PARP inhibitor eligibility.
Colorectal cancer (Lynch syndrome)
MLH1, MSH2, MSH6, PMS2, EPCAM, APC, MUTYH
Full MMR gene coverage for Lynch syndrome diagnosis, including the most clinically significant variants implicated in hereditary colorectal cancer.
Ovarian cancer
BRCA1, BRCA2, RAD51C, RAD51D, BRIP1, MLH1, MSH2
Covers both HRR and MMR aetiology – relevant for ovarian cancers with features suggesting hereditary origin.
Prostate cancer
BRCA2, ATM, CHEK2, NBN, HOXB13
Identifies hereditary prostate cancer risk and supports eligibility assessment for PARP inhibitors and other targeted therapies.
Who it's for
This test is right for you if
Your family history includes more than one cancer type. Particularly any combination of breast, colorectal, ovarian, or prostate cancer across generations
You have had a negative BRCA1/2 result but your family history or tumour features still suggest a hereditary component
Your clinician suspects Lynch syndrome or an MMR-deficient tumour and requires germline confirmation
You or your patient has a tumour with HRR or MMR aetiology and a broader germline panel is clinically indicated
BrCA vs BrRCo
Which panel is right?
BrCA panel
2 genes - BRCA1 and BRCA2
- Strong family history of breast or ovarian cancer specifically
- Known BRCA carrier in the family - cascade testing
- Rapid, focused result when the clinical question is narrow
- Most cost-effective when BRCA is the primary concern
BrCo panel
36 genes - multi-cancer coverage
- Family history spans multiple cancer types
- Prior negative BRCA result with persistent clinical suspicion
- Lynch syndrome or MMR gene involvement suspected
- Broader germline workup indicated by oncologist
Your result
What the result tells you
Results confirm the presence, absence, or uncertain significance of variants across all 36 genes in the panel.
No pathogenic variant detected
No pathogenic variant detected
No clinically significant mutation found across the 36 genes screened. A reassuring result – though population-level cancer risk remains, and surveillance recommendations depend on personal and family history.
Pathogenic variant detected
Pathogenic variant detected
A clinically significant mutation confirmed in one or more genes. Results inform surveillance planning, surgical decisions, treatment selection, and cascade testing for at-risk family members – with guidance from your genetic counsellor on next steps.
Variant of uncertain significance (VUS)
Variant of uncertain significance (VUS)
A variant is identified but its clinical significance is not yet established. Broader panels carry a higher likelihood of VUS findings. Your genetic counsellor will contextualise this finding within your personal and family history.
Sample requirements
What we need from you
Sample type
Blood (EDTA tube), saliva, or tumour sample – depending on clinical context
Tumour samples
FFPE or fresh tumour tissue accepted – collected by surgeon or pathologist
Collection
Phlebotomy arranged at a time and location convenient to you
References
Roberts ME, Jackson SA, Susswein LR, Zeinomar N, Ma X, Marshall ML, Stettner AR, Milewski B, Xu Z, Solomon BD, Terry MB, Hruska KS, Klein RT, Chung WK. MSH6 and PMS2 germline pathogenic variants implicated in Lynch syndrome are associated with breast cancer. Genet Med. 2018 Oct;20(10):1167–1174. doi: 10.1038/gim.2017.254. PMID: 29345684; PMCID: PMC6051923.
A broader question deserves a broader answer.
36 genes. Four cancer types. One test, fully interpreted by our genetics team. All processed in South Africa.