The National Comprehensive Cancer Network (NCCN v 1.2020) guidelines recommend referral to a cancer genetics professional for an individual with one or more of the following:

AFFECTED WITH BREAST CANCER

  • Breast cancer diagnosed at or before age 50
  • Triple-negative breast cancer diagnosed at or before age 60
  • Ashkenazi Jewish ancestry
  • Male breast cancer
  • A mutation identified on tumor genomic testing that has clinical implications if also identified in the germline
  • Bilateral breast cancer, first diagnosed between the ages of 50 and 65

FAMILY HISTORY OF BREAST CANCER

  • A family history of breast cancer diagnosed at or before age 50
  • A family history of triple-negative breast cancer diagnosed at or before age 60
  • Ashkenazi Jewish ancestry
  • A family history of breast cancer AND a family history of ovarian, pancreatic, or prostate cancer
  • A family history of three or more women on the same side of the family with breast cancer
  • A family history of male breast cancer
  • An affected or unaffected individual who has a probability of greater than 2.5% of a BRCA1/2 pathogenic variant based on prior probability models (eg, Tyrer-Cuzick, BRCAPro, Pennll)
  • Family history of any blood relative with a known pathogenic/likely pathogenic variant in a cancer susceptibility gene

*Referral is also clinically indicated for individuals meeting criteria but with previous limited testing (eg, single gene and/or absent deletion duplication analysis) interested in pursuing multi-gene testing

CONDITIONS TO CONSIDER

Click here to see the recommendations for breast cancer patients and genetic testing from the various medical societies.