NCCN Guidelines for Genetic Counseling
NCCN guidelines recommend referral to a genetics expert for evaluation of cancer patients and people with a strong family history of cancer if they meet any of the criteria below. Note that breast cancer includes DCIS (ductal carcinoma in situ or Stage 0 breast cancer).
- Anyone with a family history of one or more of the following:
- A blood relative with a known mutation in a gene that increases cancer risk
- A blood relative with two or more primary breast cancers
- Two or more relatives with breast cancer on the same side of the family with at least one diagnosed before age 50
- A blood relative with ovarian cancer
- A close blood relative with breast cancer before age 45
- A blood relative with male breast cancer
- Anyone of Ashkenazi Jewish ancestry with breast, ovarian, or pancreatic cancer at any age.
- Anyone with a cancer diagnosis and one or more of the following:
- A blood relative with a known mutation in a gene that increases cancer risk
- Breast cancer at or before the age of 50
- Triple-negative breast cancer at or before the age of 60
- Ovarian, fallopian tube, or primary peritoneal cancer at any age
- Male breast cancer at any age
- Anyone with breast cancer at any age and one or more of the following:
- A blood relative with a known mutation in a gene that increases cancer risk
- An Ashkenazi Jewish ancestor
- A close blood relative with breast cancer before age 50
- A close blood relative with ovarian cancer
- A second primary breast cancer
- 2 close blood relatives with breast cancer, prostate cancer (Gleason score of 7 or higher), and/or pancreatic cancer at any age
- Personal history of pancreatic cancer
- Two or more close blood relatives with breast cancer with at least one diagnosed before age 50
- Anyone with a personal or family history of three or more of the following, especially if any of the cases are diagnosed before age 50:
- Pancreatic cance, Prostate cancer, Melanoma, Sarcoma, Adrenal cancer
- Brain tumors, Leukemia, Uterine cancer, Thyroid cancer, Kidney cancer
- Diffuse gastric cancer, Colon cancer
- Anyone with metastatic prostate cancer
- Anyone with BRCA mutations detected by tumor testing