Decision Checklists & Tip Sheets

Genetic testing in people diagnosed with certain types of cancer may affect treatment options. If you have any of the following, talk to your doctor about genetic testing for an inherited mutation.

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  Breast cancer, early stage:

  • Genetic testing can help people with early-stage breast cancer learn whether they may benefit from additional treatment to lower the risk of the cancer coming back. People with inherited mutations in BRCA1, BRCA2, and PALB2, may benefit from treatment with the PARP inhibitor Lynparza (olaparib).
  • Genetic testing before surgery may help people make decisions about breast conservation or mastectomy.

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  Breast cancer, metastatic:

  • People who test positive for a BRCA1, BRCA2 or PALB2 mutation may qualify for treatment with a PARP inhibitor such as Lynparza (olaparib) or Talzenna (talazoparib).
  • People who test positive for a PTEN mutation may qualify for treatment with the targeted therapy Truqap (capivasertib). Tumor testing may also be required.
  • People who test positive for a mutation may be eligible for treatment with a targeted therapy or participation in a clinical trial.

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  Colorectal cancer, people making decisions about colorectal surgery:

  • Genetic testing may help people make decisions about undergoing more extensive colectomy surgery to prevent future cancers. Women who test positive for a Lynch syndrome mutation may have the option to undergo hysterectomy (removal of the uterus) and oophorectomy (removal of the ovaries) to lower their risk for gynecologic cancer.

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  Ovarian, fallopian tube or primary peritoneal cancer, stage that is advanced stage or recurrent:

  • People who test positive for a BRCA1 or BRCA2 mutation may qualify for maintenance therapy with a PARP inhibitor.
  • People who test positive for a mutation in another gene may qualify for treatment with a PARP inhibitor or another targeted therapy. Tumor testing may also be required. People who test positive for a mutation may be eligible for a clinical trial.

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  Pancreatic cancer:

  • People who test positive for a BRCA1, BRCA2 or PALB2 mutation may qualify for maintenance therapy with a PARP inhibitor if their pancreatic cancer didn't get worse for at least 4 months after chemotherapy . People who test positive for a mutation may be eligible for a clinical trial.

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  Prostate cancer, intermediate-risk or high-risk:

  • People who test positive for an inherited mutation may qualify for a clinical trial using a targeted therapy.

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  Prostate cancer, metastatic castration-sensitive prostate cancer (mCSPC):

  • People who test positive for a mutation in BRCA2 may qualify for treatment with the PARP inhibitor Akeega. People who test positive for a mutation may be eligible for a clinical trial.

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  Prostate cancer, metastatic castration-resistant prostate cancer (mCRPC): 

  • People who test positive for a mutation in BRCA1, BRCA2 may qualify for treatment with a PARP inhibitor such as Akeega, Lynparza, Rubraca or Talzenna.
  • People who test positive for a mutation in ATM, ATR, CDK12, CHEK2, FANCA, MLH1, MRE11A, NBN, PALB2, RAD51C or RAD51D may qualify for treatment with a PARP inhibitor such as Lynparza or Talzenna. Additional tumor testing may be needed. People who test positive for a mutation may be eligible for a clinical trial.

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  Advanced cancers of any type:

  • Genetic test results may help identify additional treatment options, such as targeted therapies approved for other cancers or eligibility for clinical trials.

If you are newly diagnosed with cancer or need to make treatment decisions, genetic testing may help inform your decisions. This can be overwhelming and you may have a lot of questions but don’t know exactly what to ask. Here is a list of commonly asked questions you may ask your medical provider, insurance company and/or genetic counselor.

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  What stage is my cancer?

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  Do the guidelines recommend genetic testing for someone in my situation?

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  I had genetic testing in the past, do I need additional genetic testing now?

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  I don't meet the testing guidelines, can I still get genetic testing?

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  Could genetic test results change my surgical treatment options? In what ways?

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  Could genetic test results change my medical treatment options? In what ways?

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  Could genetic test results affect my prognosis? If so, how?

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  Which gene mutations will you be testing me for?

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  If I test positive for an inherited mutation, would that change your recommendations for surgery or treatment?

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  If I test positive for an inherited mutation, are there additional therapies available for people with my stage and type of cancer?

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  If I test negative for an inherited mutation how does that affect my treatment options?

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  Can you refer me to a genetics expert?

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  Is my insurance likely to pay for genetic counseling and testing?

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  Could waiting on genetic test results delay my surgery or treatment?

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  Is there a risk in delaying treatment or surgery until I receive my genetic test results?

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  Are there any additional tests that can help guide my treatment decisions?

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  If I decide not to have genetic testing now, can I decide to have testing in the future? If I do, is insurance likely to pay for testing?

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  If I test positive for an inherited mutation, might I qualify for treatment with a targeted therapy?

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  Are there programs to help cover the costs for genetic testing?

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  If I test positive for a mutation, will my insurance cover the cost of targeted therapy?

Even after treatment ends, genetic testing can help you and your relatives better understand cancer risk, take steps to stay healthy, and learn whether family members are at increased or average risk. Read through the entire list below and check the signs/risk factors that are true for you and your family. If you check one or more boxes, you may benefit from genetic testing:

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  Colorectal or endometrial cancer at age 50 or younger

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  Breast cancer in both breasts or more than one breast cancer diagnosis

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  Breast cancer or prostate cancer and of Ashkenazi Jewish descent

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  Prostate cancer at age 55 or younger

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  3 or more melanomas

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  Ovarian, fallopian tube or primary peritoneal cancer at any age

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  Pancreatic cancer at any age

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  Triple-negative breast cancer at any age

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  Male breast cancer at any age

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  Metastatic prostate cancer at any age

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  A type of stomach cancer known as diffuse gastric cancer

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  Any childhood cancer

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  Any rare cancer

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  Breast cancer at age 65 or younger

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  Multiple relatives on the same side of the family with any type of cancer

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  If you had genetic testing in the past that only looked for one or a few genes and tested negative, you may benefit from additional testing.

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  If you had genetic testing before 2014 and tested negative, you may benefit from additional testing. Genetic testing has improved, and laboratories can now find gene mutations that may have previously been missed.

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  If there are cancers in the family that are not explained by earlier genetic test results, even if you or another family member previously tested positive for a mutation, updated genetic counseling and testing may help determine whether another inherited mutation could be involved.

Even after treatment ends, genetic testing can help you and your relatives better understand cancer risk, take steps to stay healthy, and learn whether family members are at increased or average risk. This can be overwhelming and you may have a lot of questions but don’t know exactly what to ask. Here is a list of commonly asked questions you may ask your medical provider, insurance company and/or genetic counselor.

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  What are the benefits of genetic testing for someone in my situation?

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  Are there any downsides to genetic testing for someone in my situation?

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  Do the guidelines recommend genetic testing for someone in my situation?

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  Could genetic test results affect my prognosis? If so, how?

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  If I test positive for a mutation, what are the certain types of cancers I need to look out for? What are my risks for these cancers?

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  If I test positive for a mutation, how will that affect my follow up care?

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  If I test positive for an inherited mutation, what does that mean for my blood relatives?

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  If I decide not to have genetic testing now, can I decide to have testing in the future?

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  I had genetic testing before 2014 and tested negative. Should I consider additional testing now?

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  I had genetic testing for only one or a few genes in the past and tested negative. Should I consider additional testing now?

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  I don't meet the testing guidelines, can I still get genetic testing?

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  How long will it take to get genetic test results?

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  Can you refer me to a genetics expert?

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  Is my insurance company likely to cover the cost of genetic testing?

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  Are there programs to help cover the costs for genetic testing?

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  How will my results affect my ability to get health insurance, life insurance, disability insurance or long term-care insurance?

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  If I don't know my family medical history, can I still get genetic testing?

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  Which gene mutations will you be testing me for?

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  I had testing through an ancestry company, do I need additional genetic testing?