Genetic Testing Before Cancer Surgery?

Not for everyone, but for certain cancers it genuinely matters. Genetic testing looks for inherited gene changes, like BRCA in breast and ovarian cancer, that can change how much tissue a surgeon should remove and whether the other side needs attention too. For most cancers it isn’t required, yet where a known gene is involved, the result can reshape the whole surgical plan. That’s why it’s considered case by case.

According to Prof. Dr. Sandeep Nayak, Surgical Oncologist in India, “When a patient carries a gene like BRCA, I plan the surgery differently, sometimes far more extensively, so I’d rather know before I operate than discover it afterwards.”

It isn’t routine for every patient, but in some situations it really earns its place. Here’s when.

• A strong family history: Several close relatives with the same cancer is a red flag that an inherited gene may be in play, and that’s worth checking first.
• Young at diagnosis: Cancer showing up unusually early often points to a genetic cause, which can change how the surgery is approached.
• Specific cancers: Breast, ovarian and colorectal cancers have well-known gene links, so testing here can directly affect the operation chosen.
• It changes the plan: If a result would mean removing more tissue or operating on both sides, knowing beforehand beats finding out later.

So testing first is about operating with the full picture. Much like what an IHC test adds at the cell level, a gene result fills in detail the surgeon needs before deciding.

When a gene shows up, it can shift the plan in real, practical ways. These are the main ones.

• Wider removal: A BRCA result in breast cancer, for instance, may steer a patient toward removing more tissue rather than a smaller operation.
• Both sides considered: Some inherited risks raise the odds for the other breast or ovary, so surgery may be planned to cover both.
• Timing other organs: A strong gene result sometimes brings forward preventive surgery on organs not yet affected.
• Family gets warning: A positive result flags risk for close relatives too, letting them screen early long before anything shows.

So the gene doesn’t just inform your surgery, it can protect your family. For suitable cases, robotic cancer surgery then carries out that tailored plan with precision.

Dr. Sandeep Nayak brings 24 years of surgical oncology experience, DNB qualifications in Surgical Oncology and General Surgery and a fellowship in Laparoscopic and Robotic Onco-Surgery to surgery across all cancer types. He factors genetic results into the surgical plan from the start, rather than treating them as an afterthought once the operation is already decided.

That forward planning is what makes a surgery fit the patient, not just the tumour. Every case at MACS Clinic goes through a full tumour board, where genetics, pathology and imaging are weighed together before anything is confirmed. Call +91 8104310753 to book your consultation.

References:

1. National Cancer Institute — Genetic Testing for Cancer. https://www.cancer.gov/
2. World Health Organisation — Cancer. https://www.who.int/news-room/fact-sheets/detail/cancer