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<sup>1</sup> <b>USPSTF 2019.</b> US Preventive Services Task Force. Risk Assessment, Genetic Counseling, and Genetic Testing for <i>BRCA</i>-Related Cancer: US Preventive Services Task Force Recommendation Statement. <i>JAMA.</i> 2019 Aug 20;322(7):652-665. <a href=https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing><u>Final recommendation statement</u></a>
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<sup>2</sup> <b>ACOG 2017.</b> Practice Bulletin Number 179: Breast Cancer Risk Assessment and Screening in Average-Risk Women. <i>Obstet Gynecol.</i> 2017 Jul;130(1):e1-e16. <a href=https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/07/breast-cancer-risk-assessment-and-screening-in-average-risk-women><u>Full-text article</u></a>
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<sup>3</sup> <b>NCCN 2024.</b> National Comprehensive Cancer Network. Breast Cancer Screening and Diagnosis (Version 2.2024). April 9, 2024. <a href=https://www.nccn.org/><u>Accessed May 31, 2024</u></a>
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<sup>4</sup> <b>NCCN 2024.</b> National Comprehensive Cancer Network. Breast Cancer Risk Reduction (Version 2.2024). March 11, 2024. <a href=https://www.nccn.org/><u>Accessed June 2, 2024</u></a>
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<sup>5</sup> <b>NCI 2024.</b> SEER Cancer Stat Facts: Female Breast Cancer. National Cancer Institute. Bethesda, MD. <a href=https://seer.cancer.gov/statfacts/html/breast.html><u>Accessed June 9, 2024</u></a>
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<sup>6</sup> <b>ACS 2023.</b> American Cancer Society Recommendations for the Early Detection of Breast Cancer. December 19, 2023. <a href=https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html><u>Accessed May 10, 2024</u></a>
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<sup>7</sup> <b>NCCN 2024.</b> National Comprehensive Cancer Network. Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic (Version 3.2024). February 12, 2024. <a href=https://www.nccn.org/><u>Accessed June 2, 2024</u></a>
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<sup>2</sup> <b>ACOG 2017.</b> Practice Bulletin Number 179: Breast Cancer Risk Assessment and Screening in Average-Risk Women. <i>Obstet Gynecol.</i> 2017 Jul;130(1):e1-e16. <a href=https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/07/breast-cancer-risk-assessment-and-screening-in-average-risk-women><u>Full-text article</u></a>
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<sup>3</sup> <b>NCCN 2024.</b> National Comprehensive Cancer Network. Breast Cancer Screening and Diagnosis (Version 2.2024). April 9, 2024. <a href=https://www.nccn.org/><u>Accessed May 31, 2024</u></a>
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<sup>4</sup> <b>NCCN 2024.</b> National Comprehensive Cancer Network. Breast Cancer Risk Reduction (Version 2.2024). March 11, 2024. <a href=https://www.nccn.org/><u>Accessed June 2, 2024</u></a>
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<sup>5</sup> <b>NCI 2024.</b> SEER Cancer Stat Facts: Female Breast Cancer. National Cancer Institute. Bethesda, MD. <a href=https://seer.cancer.gov/statfacts/html/breast.html><u>Accessed June 9, 2024</u></a>
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<sup>6</sup> <b>ACS 2023.</b> American Cancer Society Recommendations for the Early Detection of Breast Cancer. December 19, 2023. <a href=https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html><u>Accessed May 10, 2024</u></a>
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<sup>7</sup> <b>NCCN 2024.</b> National Comprehensive Cancer Network. Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic (Version 3.2024). February 12, 2024. <a href=https://www.nccn.org/><u>Accessed June 2, 2024</u></a>
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These recommendations apply to asymptomatic pts. Screen for risk factors w/ validated risk assessment tools based on FHx.<sup>1-3</sup> If screening tool (-) or pt does not meet criteria for high risk, then screen as average risk. Don’t routinely recommend genetic counseling or genetic testing if FHx not assoc w/ increased risk for <i>BRCA</i> [USPSTF-D]. If screening tool (+), refer for genetic counseling. If indicated post counseling, perform <i>BRCA</i> test [USPSTF-B].<sup>1</sup> If pedigree suggestive of, known genetic predisposition for, or compelling personal hx of AH/LCIS or FHx of breast CA, screen as high risk, refer for genetic counseling, and determine if pt wants risk-reducing tx.<sup>4</sup>