NCCN Expands Genetic Testing Criteria to Include More Women with Breast Cancer

By Eleanor Griffith, MS, CGC · Jul 2018

This article was published in 2018 and reflects NCCN criteria as of that date. NCCN guidelines are updated regularly. If you're trying to understand whether you or a family member currently meet criteria for genetic testing, a genetic counselor can help — learn more about cancer genetics or schedule an appointment.

If you have breast cancer and were previously told you didn't meet criteria for hereditary cancer testing, you may now qualify. NCCN updated BRCA testing criteria to include many more women diagnosed after age 50. A woman diagnosed with breast cancer at any age now meets criteria if she has even one close relative — first, second, or third degree — with pancreatic cancer or high-grade/metastatic prostate cancer.

Why These Specific Cancers?

These expanded criteria help reach women who inherited a hereditary mutation from their father rather than their mother — in a family with few female relatives or a paternally inherited BRCA mutation, there may be little breast cancer history, but there may be a family history of pancreatic or prostate cancer. The guidelines specify "high-grade/metastatic prostate cancer" because most prostate cancer is not aggressive and is not suggestive of a hereditary mutation.

Who Is Affected?

In 2015, there were nearly 3.5 million women living with breast cancer in the United States — most diagnosed after age 50. Many may have a family history of pancreatic or aggressive prostate cancer they've never been asked about. Insurance coverage policies tend to follow NCCN guidelines, though it typically takes about a year for changes to be reflected in insurer policies.