NCCN has published updates to the NCCN Guidelines® for Genetic/Familial High-Risk Assessment: Breast and Ovarian.

• September 22, 2016
• Clinical Practice Updates, News

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for Genetic/Familial High-Risk Assessment: Breast and Ovarian. These NCCN Guidelines^® are currently available as Version 1.2017.

• Breast and Ovarian Cancer Risk Assessment (BR/OV-1)
  • First column,
    • 2nd bullet, “An individual with a breast cancer diagnosis meeting any of the following”
      • For the 4th sub-bullet for breast cancer at any age, an additional criterion was added, “Pancreatic cancer at any age.”
    • After the criteria, the statement for referral to a genetics professional was revised, “Consider referral to cancer genetics professional .”
  • Principles of Cancer Risk Assessment and Counseling
    • Genetic testing considerations (BR/OV-A 1 of 2)
      • 5th bullet was revised from “Genetic testing for adult onset diseases (eg, BRCA1/2) in children <18 y is generally not recommended” to “In children <18 y, genetic testing is generally not recommended when results would not impact medical management.”
    • Genetic testing approach  (BR/OV-A 2 of 2)
      • 4th bullet was revised by adding, “Consider a referral to research studies that aim to define the functional impact of variants such as variant reclassification programs through clinical labs or registries.”
    • BRCA-Related Breast and/or Ovarian Cancer Syndrome
      • BRCA1/2 Testing Criteria (BRCA-1)
        • 2nd bullet, 4th sub-bullet, Diagnosed at any age with:
          • The following bullet was added, “≥2 close blood relatives with breast cancer, pancreatic cancer or prostate cancer (Gleason score ≥7) at any age.”
          • The following bullets were removed, “≥2 close blood relatives with breast cancer at any age” and “≥2 close blood relatives with pancreatic cancer and/or prostate cancer (Gleason score ≥7) at any age.”
        • 8th bullet was added, “BRCA1/2 mutation detected by tumor profiling in the absence of germline mutation analysis.”
      • BRCA Mutation-Positive Management for Women (BRCA-A 1 of 2)
        • 5th bullet,
          • 1st sub-bullet was revised, “…management of menopausal symptoms, possible short-term hormone replacement therapy , and related medical issues.”
          • 2nd sub-bullet was revised, “…In addition, in premenopausal women, oophorectomy likely reduces the risk of developing breast cancer but the magnitude is uncertain and may be gene-specific.”
        • BRCA Mutation-Positive Management for Men (BRCA-A 2 of 2)
          • 3rd bullet regarding prostate cancer was revised, “Starting at age 45 y: (See Guidelines for Prostate Early Detection).”
        • Li-Fraumeni Syndrome
          • Other cancer risks,
            • 7th bullet was revised, “Perform annual whole body MRI (or equivalent) (category 2B), preferably in context of a longitudinal study .”
          • Cowden Syndrome/PTEN Hamartoma Tumor Syndrome
            • Testing criteria was reorganized: (COWD-1)
              • 2nd bullet, “Individual with a personal history Bannayan-Riley-Ruvalcaba syndrome (BRRS)” was moved from 4th bullet to be its own criteria
              • 4th bullet was clarified by adding, “Individual not meeting clinical diagnostic criteria for CS/PH with a personal history of:”
            • Breast and Ovarian Management Based on Genetic Test Results (GENE-2, GENE-3 and GENE-4)
              • The three tables for “Breast and Ovarian Management Based on Genetic Test Results” have been extensively revised and updated.

For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium^®), the NCCN Chemotherapy Order Templates (NCCN Templates^®), and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.

To access the NCCN Biomarkers Compendium^®, please visit NCCN.org/biomarkers.

To view the NCCN Guidelines for Patients^®, please visit NCCN.org/patients.

Free NCCN Guidelines apps for iPhone, iPad, and Android devices are now available! Visit NCCN.org/apps.