According to a new guideline being published in Annals of Internal Medicine, the United States Preventive Services Task Force (USPSTF) recommends that primary care providers screen asymptomatic women with a family history of breast, ovarian, tubal, or peritoneal cancers to determine if that family history may be associated with an increased risk for potentially harmful mutations in breast cancer susceptibility genes BRCA1 or BRCA2.
Women who screen positive should have genetic counseling and, if indicated after counseling, BRCA testing. The Task Force recommends against routine genetic counseling or testing for average-risk women. The Task Force identified specific screening tools that can be used in primary care to guide referral to genetic counselors.
In general, the tools present a series of questions designed to elicit information about factors associated with increased likelihood of BRCA mutations. While the tools are all estimated to be more than 85 percent sensitive, there was not enough evidence for the Task Force to recommend one test over the other. This recommendation is reaffirms the Task Force's 2005 recommendation on BRCA testing.