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A patient’s guide

GENETIC TESTING FOR HEREDITARY CANCER

The Myriad advantage: A lifetime of patient support

MySupport360™ is a community thatn Helps guide patients and their family members

through the genetic testing processn Provides valuable information along the way and

serves as an avenue to hear from others who are facing the same decisions

Whether you are undertaking the hereditary cancer testing journey for yourself, a loved one, or a friend, MySupport360’s mission—as an addition to your medical support team—is to put you in control, enabling you to own your healthcare. MySupport360 will help keep you informed, proactive, and confidently prepared throughout the process.

Visit www.MySupport360.com to learn more.

Myriad, the Myriad logo, Myriad myRisk Hereditary Cancer, the Myriad myRisk Hereditary Cancer logo, Myriad Promise, the Myriad Promise logo, MySupport360, and the MySupport360 logo are either trademarks or registered trademarks of Myriad Genetics Inc. in the United States and other jurisdictions.

©2013, Myriad Genetic Laboratories, Inc. MRHCPTOV/07-13

NEWMyriad Genetic Laboratories, Inc.320 Wakara WaySalt Lake City, UT 841081-800-469-7423

3063 Myriad Genetics READER SPREADS CMYK

myRisk Hereditary Cancer Patient Guide Overall dull varnishProof No.: 1—07/29/13 jl Page No. 1

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Hereditary cancer and you You’ve just taken an important step in learning whether you are at risk for hereditary cancer and the management steps that can lower your risk. That’s because your healthcare provider has ordered Myriad myRisk™ Hereditary Cancer for you.

Your healthcare provider determined that myRisk was right for you because you or one or more of your relatives has had cancer and/or you matched one or more of the risk factors below. Family history alone is not enough to determine whether you are at risk for hereditary cancer. myRisk provides information about your genetic makeup that’s necessary to determine your hereditary cancer risk.

We invite you to visit www.MySupport360.com to connect with a wealth of information, resources, and a community of people on their hereditary cancer journey.

Why Myriad myRisk™ Hereditary Cancer?

Approximately 5% to 10% of all cancers develop because a person inherits a gene that is broken (mutated) in a way that allows cancer to grow. Individuals with these broken genes are far more likely to develop cancer, often at a much earlier age, than the general population. That’s why being tested with myRisk is so important.

Blends genetic information with personal and family historyThis is the only hereditary cancer test that provides information about your risk and management based on both your personal/ family cancer history and your genetic results. The experts at Myriad, who have tested more than one million patients over 15 years, have the knowledge and experience to bring genetic results and personal and family cancer history together into one fully integrated, personalized report.

Receiving your resultsYour healthcare provider may review your test report with you. Make sure all your questions are answered, and take the time you need to fully understand your results. There are pages in the back of this brochure where you can jot down questions as they occur to you. And don’t hesitate to call your provider if you think of questions at a later time.

The most important thing you can do is give your healthcare provider a complete and accurate personal and family cancer history. Keep your healthcare provider informed about any changes in your family history so that your health can be better managed.

Red flags for hereditary cancer*

An individual with, or a family history† of, any of the following:

• Breast cancer before 50

• Ovarian cancer at any age

• Two primary breast cancers in an individual at any age

• Both breast and ovarian cancer in an individual at any age

• Male breast cancer, any age

• Triple negative breast cancer, any age

• Ashkenazi Jewish descent with Hereditary Breast and Ovarian Cancer (HBOC) syndrome-associated cancer, any age‡

• Three or more HBOC syndrome-associated cancers at any age‡

• Colorectal cancer before 50

• Endometrial cancer before 50

• Two or more Lynch syndrome cancers§, any age

• A previously identified BRCA or Lynch syndrome mutation in the family

* Assessment criteria based on medical society guidelines. For these individual medical society guidelines, go to www.MyriadPro.com/guidelines.

† Family members include first-, second-, and third-degree blood relatives on both your mother and father’s sides.‡ HBOC syndrome-associated cancers include breast (including ductile carcinoma in situ [DCIS]), ovarian, pancreatic, and aggressive prostate cancers.

§ Lynch syndrome-associated cancers include colon/rectal, uterine/endometrial, ovarian, stomach/gastric, kidney/urinary tract, biliary tract, small bowel, pancreas, brain, and sebaceous adenoma cancers.



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The value of knowingRegardless of the results, you and your healthcare provider will benefit from the knowledge and insight the test provides. Knowing whether you are positive (you have a broken gene) or negative (you do not) enables you and your healthcare provider to create a personal health management plan.

If your result is negativeIt is not uncommon for cancer to “run in the family” when there is no genetic evidence of hereditary cancer. If this is the case for you, you might still have a higher risk than the general population. Your healthcare provider may want you to have screening tests more often so you can be monitored more closely. It is also important that you share your test status with your family so that they can follow up with their own healthcare providers to determine their risk.

If your result is positiveIf your result is positive, there are many ways to manage your cancer risk. Understanding the information in your report is the first step. The report your healthcare provider receives will include information about the broken gene itself and your personal and family cancer history, both of which may increase the risk for specific cancers. The myRisk™ test report will also give your healthcare provider management recommendations based on medical societies’ guidelines. Knowing what you are dealing with makes management plans more focused.

Questions you might be askingWhat does Myriad myRisk™ Hereditary Cancer do? Myriad myRisk Hereditary Cancer does not tell you whether you have cancer. Rather, it detects broken genes associated with eight specific hereditary cancers. Knowing your results enables your healthcare provider and you to take action through increased screening, preventive medicine, or preventive surgery to reduce your risk.

Why do I need a management plan if my result is negative?Just because you test negative for a broken gene does not necessarily mean that you have the same level of risk as the general population. Your or your family’s cancer history increases your risk. The most important thing you can do is give your healthcare provider a complete and accurate family cancer history. Your healthcare provider will work with you to manage your risk. Talking with other family members is very important so that they can take steps to determine their own risk.

What does a positive result mean?Learning that you are positive for a broken gene associated with hereditary cancer gives you the power to take action to reduce your risk. Your test report will help by showing options for monitoring and intervention. Your report includes recommendations made by well-established and respected medical societies. These recommendations are for discussion between you and your healthcare provider. The two of you, as well as any loved ones and family you choose, will determine the right course for you.

Myriad makes a lifetime commitment for a once-in-a-lifetime test. If new information is uncovered that changes our understanding of patients’ results, this updated information will be made available for the healthcare provider.



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Who is Myriad?Myriad has the greatest experience and insight in the field of genetic testing for hereditary cancer. Their genetic tests are known for quality and accuracy. Over the past 15 years, Myriad has tested more than one million people. The resulting knowledge base, the highly specialized professional staff, and the commitment to support healthcare providers combine to make Myriad the unquestioned leader in genetic testing for hereditary cancer.

How does Myriad support me?Myriad has developed a program for patients and families called MySupport360™. Visit www.MySupport360.com to learn what the program can offer you. Your experience can be completely personalized so that you can receive reminders about appointments and options for management. You’ll find a wealth of information of particular interest to you and your family.

Can my health insurance coverage be impacted by the results?Federal laws (HIPAA and GINA) and laws in most states prohibit discrimination regarding employment eligibility, health benefits, or health insurance premiums based solely on genetic information. Additionally, it is Myriad’s policy that test results are disclosed only to the ordering healthcare professional or designee unless the patient consents otherwise.

Will my health insurance pay for Myriad myRisk™ testing?Most insurance carriers cover genetic testing services for hereditary cancer. In fact, the average patient pays less than $100 coinsurance. Myriad helps you receive the appropriate coverage from your plan and be aware of your financial obligations greater than $375.

For additional information and support

There are many sources of information and support for patients on their hereditary cancer journey. Please visit www.MySupport360.com for resources, many related to genetic testing and hereditary cancers.

Each cancer site is associated with multiple hereditary cancer syndromes

Breast

OvarianEndometrial

ColorectalMelanoma

Pancreatic

GastricProstate



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Notes

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The Myriad advantage: Financial support and flexibility

We partner to ensure your satisfactionAt Myriad, we believe every patient should have access to the highest quality genetic testing because we know how useful it is in helping healthcare providers deliver the best medical care.

Our promisen When one of our tests is ordered for you, we will work with your insurance

provider to help you get the appropriate coverage allowed by your plann We also offer testing at no charge to uninsured patients who meet specific

financial and medical criteria. Visit https://www.myriadpro.com/financial-assistance-programs/ to learn more

n If your cost for the test will be more than $375, a Myriad customer service representative will contact you to discuss payment options

n If the cost will be $375 or less, you will not be contacted before the test starts

n If you have concerns when you receive an invoice from Myriad, you can call the telephone number on the invoice. We guarantee that we will work together to reach a solution

Our commitmentWe are committed to make sure that test results are accurate, timely, and financially accessible to everyone.



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