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.