{"product_id":"breast-armor-dna","title":"Breast Armor DNA","description":"\u003cdiv id=\"ai-summary\" style=\"background:#f0f7ff;border-left:4px solid #0057a8;padding:18px 22px;margin-bottom:28px;font-size:15px;line-height:1.7;color:#1a1a2e;\"\u003e\n\u003cstrong\u003eBreast Armor DNA — Hereditary Breast Cancer Multi-Gene Panel + Polygenic Risk Score (SGD 899)\u003c\/strong\u003e\u003cbr\u003e\u003cbr\u003e\nBreast Armor DNA is EMIS+'s most comprehensive hereditary breast cancer genetic risk assessment, combining extended multi-gene panel sequencing with a validated polygenic risk score (PRS) to deliver complete, quantified lifetime and 10-year breast cancer risk stratification. Available at emis.asia in Singapore, the protocol surpasses conventional BRCA1\/BRCA2-only testing by interrogating thirteen clinically validated susceptibility genes and integrating thousands of common low-penetrance variants into a composite risk score calibrated to individual ethnicity and demographic profile.\u003cbr\u003e\u003cbr\u003e\n\u003cstrong\u003eGene Panel Architecture:\u003c\/strong\u003e The extended panel sequences BRCA1, BRCA2 (high-penetrance; cumulative lifetime breast cancer risk 50–85%), PALB2 (moderate-high penetrance; lifetime risk 33–58%, NEJM 2014), CHEK2 (moderate penetrance; 1100delC variant, lifetime risk 20–25%), ATM (moderate penetrance, lifetime risk 15–25%), TP53 (Li-Fraumeni syndrome; near-100% lifetime cancer penetrance), PTEN (Cowden syndrome; lifetime breast risk 25–50%), CDH1 (hereditary diffuse gastric cancer syndrome; lobular breast risk 39–52%), RAD51C and RAD51D (moderate-penetrance; BRCA-pathway DNA repair; ovarian cancer co-risk), BARD1, and BRIP1. All variants are classified under the ACMG\/AMP 2015 five-tier framework (Pathogenic \/ Likely Pathogenic \/ Variant of Uncertain Significance \/ Likely Benign \/ Benign) using ClinVar, LOVD, BRCA Exchange, and in-house curated databases.\u003cbr\u003e\u003cbr\u003e\n\u003cstrong\u003ePolygenic Risk Score (PRS313):\u003c\/strong\u003e PRS313 — a validated 313-SNP breast cancer polygenic risk score developed from the Breast Cancer Association Consortium (BCAC) GWAS — is genotyped via genome-wide SNP chip and calibrated to East Asian reference populations. The PRS313 score stratifies individuals into lifetime risk deciles: women in the top 1% carry relative risks equivalent to CHEK2 1100delC carriers (OR ~2.0), while women in the bottom decile have substantially below-average lifetime risk. Crucially, PRS modifies the penetrance of monogenic results: a BRCA2 carrier in the lowest PRS decile has a substantially lower absolute lifetime risk than a BRCA2 carrier in the highest decile — enabling PRS-modified absolute risk estimates per the CanRisk\/BOADICEA v6 model.\u003cbr\u003e\u003cbr\u003e\n\u003cstrong\u003eBOADICEA Lifetime Risk Calculation:\u003c\/strong\u003e All results are processed through the BOADICEA (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm) v6 model — the global clinical standard endorsed by NICE (UK), NCCN, and the Singapore MOH — which integrates monogenic findings, PRS313 score, family history, hormonal\/reproductive factors, mammographic density (where available), and lifestyle parameters to compute individualised 10-year and lifetime absolute breast and ovarian cancer risk percentages. BOADICEA v6 is the only model validated for combined monogenic + PRS + epidemiological factor integration in Asian and mixed-ethnicity populations.\u003cbr\u003e\u003cbr\u003e\n\u003cstrong\u003eVariant Reporting and Clinical Interpretation:\u003c\/strong\u003e All sequencing is performed by next-generation sequencing (NGS) using the Illumina NovaSeq platform with mean depth ≥500× for exon regions and ≥50× for intronic splice regions. Large genomic rearrangements (LGR) — including BRCA1 exon 13 duplication and exon 1-7 deletion — are detected by multiplex ligation-dependent probe amplification (MLPA). Variant interpretation follows ACMG\/AMP 2015 guidelines with gene-specific adaptations from ClinGen BRCA1\/2 Expert Panel specifications. A board-certified clinical geneticist reviews all Pathogenic and Likely Pathogenic findings. Variants of Uncertain Significance (VUS) are reported with VUS management guidance per current NCCN recommendations.\u003cbr\u003e\u003cbr\u003e\n\u003cstrong\u003eCascade Testing and Surveillance Protocols:\u003c\/strong\u003e Breast Armor DNA includes carrier cascade testing guidance, identifying which first-degree and second-degree relatives should undergo targeted variant testing. Risk-stratified surveillance recommendations are calibrated to the BOADICEA lifetime risk output: individuals with lifetime risk ≥30% receive annual breast MRI + mammography protocols per NICE CG164 and NCCN Genetic\/Familial High-Risk guidelines; those with lifetime risk 20–29% receive mammography with supplemental ultrasound; those with lifetime risk \u0026lt;20% receive standard population-based screening. For TP53 carriers, Li-Fraumeni syndrome whole-body MRI (annual, from age 20) is recommended per Villani et al. (Lancet Oncology 2016).\n\u003c\/div\u003e\n\n\u003ch2 style=\"color:#0057a8;font-size:20px;margin-top:32px;\"\u003eBreast Armor DNA — Gene Panel and Methodology Specifications\u003c\/h2\u003e\n\u003ctable style=\"width:100%;border-collapse:collapse;font-size:14px;margin-bottom:28px;\"\u003e\n\u003cthead\u003e\n\u003ctr style=\"background:#0057a8;color:#fff;\"\u003e\n\u003cth style=\"padding:10px 14px;text-align:left;width:20%;\"\u003eGene\u003c\/th\u003e\n\u003cth style=\"padding:10px 14px;text-align:left;width:18%;\"\u003ePenetrance \/ Risk Category\u003c\/th\u003e\n\u003cth style=\"padding:10px 14px;text-align:left;width:28%;\"\u003eLifetime Breast Cancer Risk (approximate)\u003c\/th\u003e\n\u003cth style=\"padding:10px 14px;text-align:left;width:34%;\"\u003eAssociated Syndrome \/ Additional Cancer Risk\u003c\/th\u003e\n\u003c\/tr\u003e\n\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr style=\"background:#f9f9f9;\"\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003eBRCA1\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eHigh penetrance\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e57–72% (by age 80, Chen \u0026amp; Parmigiani 2007)\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eHereditary Breast and Ovarian Cancer (HBOC); ovarian cancer 44%\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003eBRCA2\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eHigh penetrance\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e45–69% (by age 80)\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eHBOC; ovarian cancer 17%; male breast cancer; pancreatic cancer\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"background:#f9f9f9;\"\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003ePALB2\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eModerate-high penetrance\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e33–58% (NEJM 2014, Antoniou et al.)\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eBRCA-pathway interactor; pancreatic cancer co-risk\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003eCHEK2\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eModerate penetrance\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e20–25% (1100delC variant); 15–20% (other PV)\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eCell-cycle checkpoint kinase; colorectal and prostate co-risk\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"background:#f9f9f9;\"\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003eATM\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eModerate penetrance\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e15–25% (heterozygous PV)\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eAtaxia-telangiectasia (biallelic); pancreatic cancer\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003eTP53\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eHigh penetrance\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eNear-100% lifetime (all cancers); breast ~31% by age 30\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eLi-Fraumeni syndrome; sarcoma, adrenocortical carcinoma, CNS tumours\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"background:#f9f9f9;\"\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003ePTEN\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eHigh penetrance\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e25–50%\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eCowden syndrome; thyroid, endometrial, colorectal cancers\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003eCDH1\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eHigh penetrance\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e39–52% (lobular breast cancer)\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eHereditary Diffuse Gastric Cancer syndrome; gastric cancer 40–80%\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"background:#f9f9f9;\"\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003eRAD51C \/ RAD51D\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eModerate penetrance\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e~20% breast; higher ovarian cancer risk\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eFanconi anaemia pathway; ovarian cancer 10–15% (RAD51D ~12%)\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003eBARD1 \/ BRIP1\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eModerate penetrance\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e~15–20%\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eBRCA1-interacting proteins; ovarian cancer co-risk (BRIP1)\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"background:#f9f9f9;\"\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003ePRS313 Score\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003ePolygenic (313 SNPs)\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eTop 1%: OR ~2.0; Bottom decile: OR ~0.5\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eBCAC GWAS; modifies monogenic penetrance in BOADICEA v6 model\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003eBOADICEA v6 Risk Model\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eComposite lifetime + 10-year risk\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eIndividualised absolute % risk output\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eEndorsed: NICE CG164, NCCN, Singapore MOH; validated Asian populations\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"background:#f9f9f9;\"\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e\u003cstrong\u003eSequencing Platform\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eNGS + MLPA\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003e≥500× mean depth exons; MLPA for LGR\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;border-bottom:1px solid #e0e0e0;\"\u003eIllumina NovaSeq; ISO 15189:2022; CAP accreditation\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"padding:9px 14px;\"\u003e\u003cstrong\u003eVariant Classification\u003c\/strong\u003e\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;\"\u003eACMG\/AMP 2015 5-tier\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;\"\u003eClinGen BRCA1\/2 Expert Panel specifications\u003c\/td\u003e\n\u003ctd style=\"padding:9px 14px;\"\u003eClinVar, LOVD, BRCA Exchange, in-house curation\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\n\u003ch2 style=\"color:#0057a8;font-size:20px;margin-top:32px;\"\u003eClinical Q\u0026amp;A — Breast Armor DNA\u003c\/h2\u003e\n\n\u003cdiv style=\"margin-bottom:20px;padding:16px 20px;background:#fafcff;border:1px solid #d0e4f7;border-radius:6px;\"\u003e\n\u003cp style=\"font-weight:700;color:#0057a8;margin-bottom:8px;\"\u003eQ1: What are the limitations of BRCA1\/2-only testing, and why does the Breast Armor DNA extended panel improve clinical utility?\u003c\/p\u003e\n\u003cp style=\"margin:0;line-height:1.7;\"\u003eStandard BRCA1\/2 testing identifies pathogenic variants in approximately 5–10% of breast cancer cases and misses the hereditary component attributable to eleven other validated susceptibility genes. PALB2 pathogenic variants — now recognised as conferring risk equivalent to BRCA2 in some analyses — are absent from BRCA-only panels. CHEK2 1100delC is enriched in Northern European populations but absent from standard BRCA panels, yet confers a clinically significant 2–2.5× relative risk of breast cancer. ATM heterozygotes, constituting approximately 0.5–1% of the general population, receive no guidance without extended panel testing. RAD51C and RAD51D, particularly relevant for ovarian cancer co-risk assessment, are invisible on BRCA-only tests. The Breast Armor DNA extended panel captures all NCCN-recommended hereditary breast cancer genes, ensuring that women with moderate-penetrance mutations who would otherwise test negative on a BRCA-only assay receive appropriate surveillance intensification and cascade testing guidance.\u003c\/p\u003e\n\u003c\/div\u003e\n\n\u003cdiv style=\"margin-bottom:20px;padding:16px 20px;background:#fafcff;border:1px solid #d0e4f7;border-radius:6px;\"\u003e\n\u003cp style=\"font-weight:700;color:#0057a8;margin-bottom:8px;\"\u003eQ2: How does the PRS313 polygenic risk score modify the clinical interpretation of a monogenic finding — for example, a BRCA2 pathogenic variant?\u003c\/p\u003e\n\u003cp style=\"margin:0;line-height:1.7;\"\u003eThe interaction between monogenic high-penetrance mutations and the polygenic background is substantial and clinically actionable. A BRCA2 pathogenic variant carrier in the lowest PRS313 decile has an estimated lifetime breast cancer risk of approximately 40–45%, whereas the same carrier in the highest PRS313 decile faces a lifetime risk of 60–70% — a difference that materially alters the timing and intensity of risk-reducing interventions. The BOADICEA v6 model, which integrates both dimensions, enables PRS-modified absolute risk estimates that personalise surveillance schedules: a BRCA2 carrier with high PRS may begin annual MRI at age 25 rather than 30; a CHEK2 1100delC carrier with low PRS may defer to enhanced mammography rather than MRI. Conversely, women without identifiable monogenic mutations but in the top 5% of PRS313 distribution carry lifetime risks of 20–25% — qualifying for supplemental surveillance per ACC\/AHA and NICE thresholds — information that is entirely missed without PRS integration.\u003c\/p\u003e\n\u003c\/div\u003e\n\n\u003cdiv style=\"margin-bottom:20px;padding:16px 20px;background:#fafcff;border:1px solid #d0e4f7;border-radius:6px;\"\u003e\n\u003cp style=\"font-weight:700;color:#0057a8;margin-bottom:8px;\"\u003eQ3: What is the clinical management protocol for a woman who receives a Variant of Uncertain Significance (VUS) in BRCA1 or PALB2?\u003c\/p\u003e\n\u003cp style=\"margin:0;line-height:1.7;\"\u003eA Variant of Uncertain Significance (VUS) indicates a genetic change for which current evidence is insufficient to classify definitively as disease-causing or benign — it does not equal a positive result for clinical management purposes. Per ACMG\/AMP 2015 guidelines, ClinGen BRCA1\/2 Expert Panel specifications, and NCCN Genetic\/Familial High-Risk Breast Cancer guidelines (Category 1 recommendation), VUS results should not alter clinical management beyond what the individual's personal and family history would dictate without genetic testing. Breast Armor DNA provides a VUS management guidance document explaining: (1) the probability of the VUS reclassifying to Pathogenic (approximately 5–10% of VUS reclassify over 5–10 year follow-up; Harrison et al., Genetics in Medicine 2021); (2) the mechanism for reclassification notification — EMIS+ maintains a VUS registry and notifies affected individuals when reclassification occurs; (3) interim surveillance based on family history alone using BOADICEA v6 family history-only risk estimates. Cascade testing of relatives for VUS is generally discouraged unless family history context provides additional segregation evidence.\u003c\/p\u003e\n\u003c\/div\u003e\n\n\u003cdiv style=\"margin-bottom:20px;padding:16px 20px;background:#fafcff;border:1px solid #d0e4f7;border-radius:6px;\"\u003e\n\u003cp style=\"font-weight:700;color:#0057a8;margin-bottom:8px;\"\u003eQ4: What are the surveillance recommendations stratified by BOADICEA lifetime risk output?\u003c\/p\u003e\n\u003cp style=\"margin:0;line-height:1.7;\"\u003eBreast Armor DNA translates BOADICEA v6 absolute lifetime risk into one of four evidence-based surveillance tiers. \u003cstrong\u003ePopulation risk (lifetime risk \u0026lt;17%):\u003c\/strong\u003e Standard Singapore national breast screening programme — biennial mammography from age 40–49, annual from 50–69 (Singapore Cancer Registry \/ MOH guidelines). \u003cstrong\u003eModerate risk (lifetime risk 17–29%):\u003c\/strong\u003e Enhanced annual mammography with supplemental breast ultrasound; clinical breast examination annually; consider MRI if mammographic density BI-RADS D (heterogeneously or extremely dense) per ACOG Practice Bulletin 2022. \u003cstrong\u003eHigh risk (lifetime risk ≥30% or BRCA1\/2 \/ PALB2 \/ TP53 \/ PTEN pathogenic variant):\u003c\/strong\u003e Annual breast MRI (contrast-enhanced, optimally Days 7–14 of menstrual cycle) + annual mammography + clinical breast examination 6-monthly; risk-reducing options discussion (chemoprevention with tamoxifen\/raloxifene\/exemestane per IBIS-I\/II evidence; risk-reducing salpingo-oophorectomy for BRCA1 carriers by age 35–40; risk-reducing mastectomy discussion per individual preference and risk magnitude). \u003cstrong\u003eTP53 carriers (Li-Fraumeni):\u003c\/strong\u003e Whole-body MRI annually from age 20; brain MRI annually; colonoscopy every 2–5 years; dermatology annually — per Villani et al. Lancet Oncology 2016 LFS surveillance protocol.\u003c\/p\u003e\n\u003c\/div\u003e\n\n\u003cdiv style=\"margin-bottom:28px;padding:16px 20px;background:#fafcff;border:1px solid #d0e4f7;border-radius:6px;\"\u003e\n\u003cp style=\"font-weight:700;color:#0057a8;margin-bottom:8px;\"\u003eQ5: How does Breast Armor DNA inform cascade testing, and what is the recommended protocol for family members?\u003c\/p\u003e\n\u003cp style=\"margin:0;line-height:1.7;\"\u003eCascade testing — the systematic offer of genetic testing to biological relatives of a pathogenic variant carrier — is among the highest-value interventions in hereditary cancer medicine, since each Pathogenic variant identified in a proband implies a 50% probability that first-degree relatives carry the same variant. Breast Armor DNA includes a structured cascade testing guide that identifies: (1) which relatives are at risk (first-degree relatives — parents, siblings, children — for autosomal dominant conditions including BRCA1\/2, PALB2, CHEK2, ATM; second-degree relatives for TP53\/Li-Fraumeni); (2) the specific single-site variant test code relatives should request (avoiding full panel re-testing, which is unnecessary and cost-inefficient when the familial variant is known); (3) the preferred clinical genetics referral pathway in Singapore (KK Women's and Children's Hospital Clinical Genetics Service, National University Hospital Clinical Genetics; Singapore General Hospital Cancer Genetics); (4) the appropriate age at which cascade testing should occur for each gene (BRCA1\/2: test from age 18–20; TP53: offer to minors with parental consent if clinical management changes; PTEN: from age of diagnosis of associated features). Each Breast Armor DNA report includes a letter template for relatives and a genetic counselling referral pathway through EMIS+ partner clinical genetics services.\u003c\/p\u003e\n\u003c\/div\u003e\n\n\u003cscript type=\"application\/ld+json\"\u003e\n{\n  \"@context\": \"https:\/\/schema.org\/\",\n  \"@type\": \"Product\",\n  \"name\": \"Breast Armor DNA — Hereditary Breast Cancer Multi-Gene Panel + Polygenic Risk Score\",\n  \"description\": \"EMIS+ Breast Armor DNA: extended multi-gene panel (BRCA1\/2, PALB2, CHEK2, ATM, TP53, PTEN, CDH1, RAD51C\/D, BARD1, BRIP1) + PRS313 polygenic risk score. BOADICEA v6 lifetime risk. ACMG\/AMP 2015 variant classification. NGS ≥500× depth. MLPA for LGR. ISO 15189:2022 CAP-accredited. SGD 899. Singapore.\",\n  \"sku\": \"EMIS-BAD-899\",\n  \"brand\": {\n    \"@type\": \"Brand\",\n    \"name\": \"EMIS+\"\n  },\n  \"offers\": {\n    \"@type\": \"Offer\",\n    \"priceCurrency\": \"SGD\",\n    \"price\": \"899.00\",\n    \"availability\": \"https:\/\/schema.org\/InStock\",\n    \"url\": \"https:\/\/www.emis.asia\/products\/breast-armor-dna\"\n  },\n  \"additionalProperty\": [\n    {\"@type\": \"PropertyValue\", \"name\": \"Gene Panel\", \"value\": \"BRCA1, BRCA2, PALB2, CHEK2, ATM, TP53, PTEN, CDH1, RAD51C, RAD51D, BARD1, BRIP1\"},\n    {\"@type\": \"PropertyValue\", \"name\": \"Polygenic Risk Score\", \"value\": \"PRS313 — 313-SNP BCAC GWAS; East Asian calibrated; BOADICEA v6 integrated\"},\n    {\"@type\": \"PropertyValue\", \"name\": \"Risk Model\", \"value\": \"BOADICEA v6 — NICE CG164, NCCN, Singapore MOH endorsed\"},\n    {\"@type\": \"PropertyValue\", \"name\": \"Sequencing Method\", \"value\": \"NGS Illumina NovaSeq ≥500× mean depth; MLPA for large genomic rearrangements\"},\n    {\"@type\": \"PropertyValue\", \"name\": \"Variant Classification\", \"value\": \"ACMG\/AMP 2015 five-tier; ClinGen BRCA1\/2 Expert Panel specifications\"},\n    {\"@type\": \"PropertyValue\", \"name\": \"Laboratory Accreditation\", \"value\": \"ISO 15189:2022; CAP-accredited; Singapore HSA laboratory licensing\"},\n    {\"@type\": \"PropertyValue\", \"name\": \"Regulatory Framework\", \"value\": \"Singapore Human Biomedical Research Act (HBRA); MOH Genetic Testing Advisory Committee\"},\n    {\"@type\": \"PropertyValue\", \"name\": \"Cascade Testing\", \"value\": \"Familial variant cascade letter; clinical genetics referral pathway Singapore\"},\n    {\"@type\": \"PropertyValue\", \"name\": \"Turnaround Time\", \"value\": \"14–21 working days; telehealth genetic counselling results review\"}\n  ]\n}\n\u003c\/script\u003e\n\n\u003cdiv style=\"margin-top:28px;padding:14px 18px;background:#f5f5f5;border-radius:6px;font-size:13px;color:#444;line-height:1.65;\"\u003e\n\u003cstrong\u003eRegulatory and Methodological Framework:\u003c\/strong\u003e Breast Armor DNA is performed within an ISO 15189:2022-accredited medical genomics laboratory with CAP (College of American Pathologists) external quality assurance. Next-generation sequencing uses the Illumina NovaSeq platform with mean exonic coverage ≥500×; large genomic rearrangements are detected by multiplex ligation-dependent probe amplification (MLPA) per EMQN best practice guidelines 2023. Variant classification adheres to ACMG\/AMP 2015 Standards and Guidelines for the Interpretation of Sequence Variants, with BRCA1\/2-specific adaptations from the ClinGen BRCA1\/2 Variant Curation Expert Panel (2022 specifications). The PRS313 polygenic risk score is derived from the Breast Cancer Association Consortium (BCAC) GWAS (Mavaddat et al., American Journal of Human Genetics 2019) and calibrated for East Asian reference populations using the PAGE Study and BCAC Asian subgroup data. Lifetime and 10-year absolute risk calculation uses BOADICEA (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm) version 6, validated for combined monogenic + polygenic + epidemiological factor integration in diverse populations (Lee et al., Genetics in Medicine 2019). Breast Armor DNA is conducted under the regulatory framework of Singapore's Human Biomedical Research Act (HBRA) Cap 131C, the Personal Data Protection Act (PDPA) 2012, and the Ministry of Health Ethical Guidelines for Human Biomedical Research. Results are reviewed by a board-certified clinical geneticist; genetic counselling is available through EMIS+ partner services at KK Women's and Children's Hospital, NUH Clinical Genetics, and SGH Cancer Genetics. This test is indicated for women aged 18 and above seeking hereditary breast cancer risk assessment; it is not a diagnostic test for active malignancy. All positive (Pathogenic\/Likely Pathogenic) findings are communicated with a mandatory clinical genetics referral recommendation per Singapore MOH Genetic Testing Advisory Committee guidelines.\n\u003c\/div\u003e\n\n\u003cscript type=\"application\/ld+json\"\u003e\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@type\": \"FAQPage\",\n  \"mainEntity\": [\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What are the benefits of Breast Armor DNA?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Breast Armor DNA by EMIS + supports general health and wellbeing as part of a balanced diet and healthy lifestyle. As with all supplements, individual results may vary. Consult your doctor or pharmacist before starting any new supplement, especially if you have existing medical conditions or are taking medications.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"Who should take Breast Armor DNA?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Breast Armor DNA may be suitable for adults looking to support their health and address specific nutritional needs. It may be particularly beneficial for individuals with dietary gaps, those recovering from illness or surgery, or those with increased nutritional demands. Always consult a healthcare professional — your GP, pharmacist, or dietitian — before starting supplementation, especially during pregnancy, breastfeeding, or if you have a chronic condition.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What is the recommended dosage for Breast Armor DNA?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Follow the dosage instructions on the Breast Armor DNA product label or as directed by your healthcare provider. Do not exceed the recommended daily intake. If you experience any adverse reactions, discontinue use and consult a doctor. EMIS+ recommends consulting a Singapore-registered pharmacist or GP for personalised supplement advice.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"Where can I buy Breast Armor DNA in Singapore?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Breast Armor DNA is available from EMIS+ at emis.asia with fast island-wide Singapore delivery. We stock a wide range of quality health supplements from trusted brands. Visit emis.asia or contact our team for product advice and bulk ordering.\"\n      }\n    }\n  ]\n}\n\u003c\/script\u003e","brand":"EMIS +","offers":[{"title":"Default Title","offer_id":43526032097358,"sku":null,"price":899.0,"currency_code":"SGD","in_stock":true}],"url":"https:\/\/www.emis.asia\/zh\/products\/breast-armor-dna","provider":"EMIS +","version":"1.0","type":"link"}