HRD stands for homologous recombination deficiency. Simply put, HRD means a cell can’t repair certain types of DNA damage that naturally occur in your body. This results in accumulation of mutations (changes to DNA) and instability in cells, which can lead to cancer. HRD is a characteristic of many ovarian cancer tumors.

HRD can be identified in two different ways:

  1. Individual mutations—breast cancer susceptibility genes 1 or 2 (BRCA1 or BRCA2)
  2. Genomic instability markers including loss of heterozygosity (LOH), large-scale state transitions (LST) and telomeric allelic imbalance (TAI)—large-scale structural rearrangements of chromosomes

A positive HRD test means that ovarian cancer tumor cells cannot repair certain DNA damage accurately. This affects how cancer progresses in the tumor and how it responds to different treatments.

HRD is caused by problems in essential DNA repair mechanisms and can affect how your cancer cells grow, die, and respond to certain treatments.

You can be born with inherited mutations that may cause HRD—they may be passed down from both women and men to their children. However, some mutations that cause HRD can also be acquired during your life. For example, BRCA mutations, one cause of HRD, can be inherited or acquired.

HRD results in additional changes in your tumor’s DNA, and these changes may develop during your lifetime.

The National Comprehensive Cancer Network® Guidelines for Ovarian Cancer recommends all people with confirmed ovarian cancer get tumors tested for BRCA mutations, which can be done with an HRD test.

An HRD test must be ordered by your healthcare provider and performed in a clinical setting. It requires a tumor tissue sample, taken through a biopsy or during surgery. Your healthcare team may be able to use tissue from your original biopsy to conduct the HRD test. You may not need an additional procedure.

Talk to your healthcare team about getting tested as soon as possible after an ovarian cancer diagnosis and after any recurrence.

Ideally, you should talk to your doctor about getting tested as soon as possible after diagnosis. But wherever you are in your treatment journey, it’s important to talk to your doctor about HRD testing.

BRCA stands for BReast CAncer susceptibility gene. Everyone has BRCA1 and BRCA2 genes, which are responsible for tumor suppression. But when these genes are mutated, their normal function may be altered. This means tumors are more likely to occur.

If you have certain BRCA mutations, you’re at a higher risk of developing certain cancers, including ovarian cancer and breast cancer. If you test positive for BRCA mutations, you may want to consider scheduling regular cancer screenings. And if you have already been diagnosed with cancer, knowing that you have a BRCA mutation can help determine whether or not you can receive treatments specifically tailored for people with BRCA mutations. Because BRCA mutations can be hereditary, knowing your BRCA status can inform you and your family’s potential risk of cancer.

BRCA mutations are one cause of HRD, but they are not the only cause. If you are BRCA-negative, it’s important to get an HRD test.

You can learn more about BRCA mutations at beBRCAware.com.

If you get an HRD test, you do not need a separate BRCA test to determine if you have BRCA mutations. An HRD test will also identify BRCA gene mutations, which can inform treatment options and indicate your risk of developing other cancers.

But even if you have already been tested for BRCA and are BRCA-negative, you should still talk to your doctor about HRD testing. BRCA mutations only account for half of HRD-positive tumors. You may be BRCA-negative and still be HRD-positive.

You can learn more about BRCA at beBRCAware.com.

Biomarker testing, like HRD, uncovers specific characteristics of cancer cells, which can determine how tumors will grow and evolve, as well as how they may respond to different treatments. HRD is a biomarker that appears in about 50% of women with advanced ovarian cancer.

Yes. Your tumor’s HRD status can help you and your healthcare team identify the most appropriate treatments for you.

A genetic test examines specific inherited genes in your DNA. Genetic tests can help identify the potential risk of developing certain diseases, including some cancers. For example, a genetic test can show inherited BRCA mutations that increase the risk of developing ovarian cancer or breast cancer. A blood or saliva sample will be collected for a genetic test.

A tumor test, also known as a genomic test or a biomarker test, looks at all the genes in your tumor’s DNA. A tumor test requires a tissue sample from the tumor and can find both inherited and acquired mutations when also paired with a blood or saliva test.

Your doctor can help you understand HRD testing and address any concerns you might have. You can ask about the specifics of the procedure, what they’ll learn from the results, and what you can expect following the test. Visit the Doctor Discussion Guide for some important questions and talking points that can help guide your conversation.

If you have ovarian cancer, testing for HRD may be covered. Call your insurance provider to ask about coverage.