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

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.

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