This grid can give a quick breakdown of the different societies and their recommendations for genetic testing in women with a personal or family history of breast cancer:
Group | Recommend Genetic Testing for all people? | Recommend genetic testing for all women with breast cancer? | Recommend genetic testing for people who met personal or family history criteria? | Type of testing recommended: BRCA1/2 | Type of testing recommended: Bigger gene panel | If bigger gene panel, guidelines on which genes to include? | Recommend genetic counseling? |
National Comprehensive Cancer Network (NCCN) | No | No | Yes | Yes | Depends | Yes, BRCA1, BRCA2, CDH1, PTEN, and TP53 mentioned, guidelines for others | Yes, can be GC, medical geneticist, oncologist, surgeon, oncology nurse, or other health professional with expertise |
American Society of Breast Surgeons | No | Yes | Yes, follows NCCN criteria | Yes | At least PALB2, other genes as appropriate* | No, lack of consensus | Yes, by breast surgeons, GCs, or other HCPs |
USPSTF | No | No | Yes *women only | Yes | No | n/a | Yes, by any trained providers including PCPs |
American College of Medical Genetics (ACMG) | No | No | Yes | Yes | No (made before panels were commonplace) | n/a | Yes, by any trained providers who have adequate time |
American Society of Clinical Oncology (ASCO) | No | No | Yes | Yes | Yes | No | Yes, they include their own standards for training, prefer multidisciplinary team |
American College of Obstetricians and Gynecologists (ACOG) | No | No | Yes | Yes | Yes | No | Yes |
Society for Gynecologic Oncology | No | No | Yes | Yes | Depends | Yes, includes Lynch for gyn malignancies | Yes, GCs preferred, but can be performed by others with appropriate training when needed |
National Institute for Health and Care Excellence | No | No | Yes, if risk of testing positive is over 10% | Yes | Yes | Yes, TP53 for breast cancer patients | Yes, but only if patient voices concern |
European Society for Medical Oncology | No | No | Yes, follows NCCN and NICE criteria | Yes | Depends | No | Yes |
*also updated testing for anyone prior to 2014
ALL guidelines advocate the following:
Other important guideline information: