Medical Oncologist
CION Cancer Clinics
Genetic testing before preventive surgery | CION Cancer Clinics
A genetic test almost always comes before preventive cancer surgery. Surgeons do not remove a healthy organ on a family story alone: the test shows whether you inherited a fault, which organs it affects, and how high your risk really is. This page explains the testing pathway, the four kinds of result and what each one means for surgery, and what no gene test can tell you. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Do I need a genetic test before preventive surgery?
- What does the testing pathway actually look like?
- What can the result say, and what does each one mean for surgery?
- Why is the relative with cancer tested before me?
- Words on a genetics report, in plain language
- Four things families tell us, and what is actually true
- What can the test not tell you?
- Common questions about genetic testing before preventive surgery
The short answer
Do I need a genetic test before preventive surgery?
Almost always, yes. A surgeon will not remove a healthy organ on the strength of a family story alone. The gene test is what turns a worry into a measured risk, and the measured risk is what decides whether surgery is even discussed.
Why the test comes before the surgeon
Two people from the same family can carry very different risks. One inherited the fault; the other did not. Without a test, both look the same on paper. With a test, the person who did not inherit it is spared an operation they never needed, and the person who did can plan with real numbers. The test also tells the team which organs are at risk, because different faults point at different cancers.
The one exception
Some families have several early cancers but no fault can be found, or nobody affected is alive to be tested. A genetics team can still class a person as high risk from the family tree alone, and surgery may then be discussed. This is less common, and the risk estimate is less precise, which the team will say plainly.
Testing is your decision. You can be counselled and then decide not to be tested, and nobody will treat that as the wrong answer.What happens
What does the testing pathway actually look like?
Counselling first
A genetic counsellor or geneticist draws your family tree, works out whether a test is likely to be useful, and explains what each result would mean for you and your relatives.
Who gets tested first
Where possible, a relative who has had the cancer is tested first. If a fault is found in them, everyone else in the family can be tested for that one exact change, which is quicker and clearer.
The sample
A blood sample, or sometimes saliva. Nothing else is needed. The sample goes to a laboratory that reads the genes linked to your family's pattern of cancers.
The result meeting
Results take weeks rather than days. They are given in person, with time to ask questions, and the options are laid out only after the result is understood.
Not sure whether this applies to you?
Ask an oncologistReading the result
What can the result say, and what does each one mean for surgery?
There are more than two answers. This is where most of the confusion in families begins.
A fault is found
Called a pathogenic variant, or "positive". Your risk of the linked cancers is much higher than usual. Surgery becomes one of the options, alongside regular checks.
What it is not
- A diagnosis of cancer
- A certainty that cancer will come
No fault found, and the family fault is known
A "true negative". You did not inherit the change that runs in your family, your risk is close to the general population, and you cannot pass it on. Preventive surgery is not offered.
No fault found, and the family fault is not known
An "uninformative negative". The test did not find a change, but the family pattern is still unexplained. Your risk may still be raised, and checks may be advised on the family tree alone.
A change of uncertain meaning
A variant of uncertain significance, or VUS. Science does not yet know whether it matters. It is not treated as positive, and surgery is not offered because of it. Laboratories re-classify these over time, so keep in touch with the genetics service.
Side by side
Why is the relative with cancer tested before me?
Testing the relative who had cancer first
Testing you directly
Looks across many genes to find what explains the family
Looks across many genes without knowing what to expect
If a fault is found, your own test is a single, clear check for it
A negative result is harder to interpret, because the family fault is still unknown
Needs an affected relative who is alive and willing
The only route when no affected relative can be tested
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
On your report
Words on a genetics report, in plain language
- Germline
- A change you were born with, carried in every cell, and able to be passed on. This is the kind of test used before preventive surgery.
- Somatic
- A change found only in the tumour, not inherited. A tumour test can hint at an inherited fault, but a blood test is needed to confirm it.
- Panel test
- A test that reads several cancer genes at once rather than one. Most first tests in a family are panel tests.
- Predictive test
- A test for one known family fault in a person who has not had cancer. This is usually the test you have once a relative's fault is known.
- Cascade testing
- Offering the predictive test to relatives one by one, once a fault is found in the family.
Commonly believed
Four things families tell us, and what is actually true
"A positive test means I will get cancer."
It means your chance is much higher than usual. It is still a chance, and some carriers never develop the cancer. That is why the result opens a choice between checks and surgery, rather than a booking.
"My mother tested negative, so I do not need testing."
Only true if the family fault is known and your mother was tested for it. A fault can also come down the father's side, which families often overlook. A counsellor will tell you whether her result covers you.
"A home test kit from the internet is enough to decide on surgery."
Consumer kits check a handful of changes and miss most of the faults that matter. No surgeon will plan an operation on one. A clinical test through a genetics service, read by a laboratory, is what is needed.
"If I test, my insurer will find out and cancel my policy."
Your result is confidential medical information. How insurers treat genetic results varies, and it is a fair question to raise at counselling before you decide. It is not a reason to skip counselling itself.
Being straight with you
What can the test not tell you?
A gene test cannot tell you whether you will get cancer, when, or how serious it would be. It gives a chance, not a forecast. It also cannot tell you whether to have surgery. That is a decision built on the result, your age, your plans for children and how you feel about the alternatives.
Who testing does not suit right now
Someone in the middle of cancer treatment may be advised to wait until they are through it. A child is usually not tested for faults that cause cancer in adulthood, so that the choice is theirs later. And a person who does not want to know is entitled to that, though relatives may still be tested.
What this page cannot do
It cannot read your report, and it cannot tell you what your family pattern means. Both need a counsellor with the tree in front of them. If you have a result in your hand and nobody has explained it, that is the appointment to ask for first, before any surgical one.
Bring every relative's report you can find to counselling, including old ones. The cancer type and the age at diagnosis are what the counsellor needs.Questions we are asked
Common questions about genetic testing before preventive surgery
How long does the result take?
Usually several weeks, sometimes longer for a wide panel test. A predictive test for a single known family fault is often quicker. Ask at the time of the sample, and ask who will call you. The result is given in person, so it is worth booking that meeting when you give the sample.
Can I be tested if I already have cancer?
Yes, and in many families you are the right person to test first, because a fault found in you tells everyone else which change to look for. Your oncologist may raise it during treatment planning, since some results also change the treatment itself. The blood sample is the same.
The affected relative has died. Can we still test?
Yes. A close unaffected relative can be tested directly, though a negative result then means less because the family fault was never identified. Occasionally a stored tissue block from the relative's biopsy can be tested. Ask the genetics service; they will say which route makes sense for your family.
Will the test change my cancer treatment as well as preventive surgery?
It can. Some faults change which surgery or which medicines are recommended for a cancer that has already been found. That is one reason oncologists now ask about family history at the first visit. If you are being treated, tell your oncologist you are being tested so the two plans are read together.
What does the test cost, and is it covered?
Cost varies with the laboratory and the size of the panel, and a single predictive test is usually much cheaper than a wide one. Cover under Aarogyasri, CGHS, ECHS, EHS or cashless insurance varies. Ask the genetics service for a written estimate and bring your scheme card or policy so cover can be checked.
My result is a VUS. What happens now?
Nothing surgical. A variant of uncertain significance is not treated as positive. Your checks are planned on your family history, as if the test had not been done. Laboratories re-classify these changes as knowledge grows, so give the genetics service a contact number and ask how you will be told if that happens.
Should my children be tested?
For most faults that cause cancer in adulthood, testing waits until your child is an adult and can choose. A few conditions such as FAP and MEN2 are tested for in childhood because the risk starts early. Your counsellor will tell you which applies, and how to talk to your children about it when the time comes.
Can I skip the test and go straight to a surgeon?
You can see a surgeon, but they will ask for the genetics assessment before discussing an operation. Without a measured risk, removing a healthy organ is hard to justify and most surgeons will decline. The assessment protects you from an operation you may not need as much as it opens the door to one.
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Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- National Cancer Institute — Genetic Testing for Inherited Cancer Susceptibility Syndromes
- National Cancer Institute — BRCA Gene Changes: Cancer Risk and Genetic Testing
- NHS — Predictive genetic tests for cancer risk genes
- Cancer.Net — Genetics
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Who Is Offered Risk-Reducing Surgery?Which results and family patterns lead to the surgical offerTalking to Your Family About Genetic RiskA result in one person is a result for relatives tooSurveillance Instead of Preventive SurgeryWhat regular checks involve if you choose not to operateRisk-Reducing Surgery: Operating Before Cancer HappensThe operations the test may lead to
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