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Understanding BRCA & HBOC > Risk Management > Risk Management Guidelines

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Risk Management Guidelines

Learn about the steps that people at high risk for cancer can take to manage their risk and protect their health.

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
  • 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 cancer
    • Prostate cancer
    • Melanoma
    • Sarcoma
    • Adrenal cancer
    • Brain tumors
    • Leukemia
    • Uterine cancer
    • Thyroid cancer
    • Kidney cancer
    • Diffuse gastric cancer
    • Colon cancer

Updated 3/10/16

FORCE:Facing Our Risk of Cancer Empowered