1932

Abstract

The discovery of genes underlying inherited predisposition to breast and ovarian cancer has revolutionized the ability to identify women at high risk for these diseases before they become affected. Women who are carriers of deleterious variants in these genes can undertake surveillance and prevention measures that have been shown to reduce morbidity and mortality. However, under current strategies, the vast majority of women carriers remain undetected until they become affected. In this review, we show that universal testing, particularly of the and genes, fulfills classical disease screening criteria. This is especially true for and in Ashkenazi Jews but is translatable to all populations and may include additional genes. Utilizing genetic information for large-scale precision prevention requires a paradigmatic shift in health-care delivery. To address this need, we propose a direct-to-patient model, which is increasingly pertinent for fulfilling the promise of utilizing personal genomic information for disease prevention.

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2020-08-31
2024-04-19
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Literature Cited

  1. 1. 
    Allyse MA, Robinson DH, Ferber MJ, Sharp RR 2018. Direct-to-consumer testing 2.0: emerging models of direct-to-consumer genetic testing. Mayo Clin. Proc. 93:113–20
    [Google Scholar]
  2. 2. 
    Alsop K, Fereday S, Meldrum C, deFazio A, Emmanuel C et al. 2012. BRCA mutation frequency and patterns of treatment response in BRCA mutation-positive women with ovarian cancer: a report from the Australian Ovarian Cancer Study Group. J. Clin. Oncol. 30:2654–63
    [Google Scholar]
  3. 5. 
    Anderson K, Jacobson JS, Heitjan DF, Zivin JG, Hershman D et al. 2006. Cost-effectiveness of preventive strategies for women with a BRCA1 or a BRCA2 mutation. Ann. Intern. Med. 144:397–406
    [Google Scholar]
  4. 6. 
    Arbeitsgem. Gynäkol. Onkol. (AGO) 2019. Breast cancer risk and prevention Guidel. Breast Version 2019.1, AGO, Taufkirchen, Gerl https://www.ago-online.de/fileadmin/ago-online/downloads/_leitlinien/2019/PDF_EN/2019E_02_Breast_Cancer_Risk_and_Prevention.pdf
  5. 7. 
    Armstrong J, Toscano M, Kotchko N, Friedman S, Schwartz MD et al. 2015. Utilization and outcomes of BRCA genetic testing and counseling in a national commercially insured population: the ABOUT study. JAMA Oncol 1:1251–60
    [Google Scholar]
  6. 8. 
    Armstrong K, Schwartz JS, Randall T, Rubin SC, Weber B 2004. Hormone replacement therapy and life expectancy after prophylactic oophorectomy in women with BRCA1/2 mutations: a decision analysis. J. Clin. Oncol. 22:1045–54
    [Google Scholar]
  7. 9. 
    Armstrong N, Ryder S, Forbes C, Ross J, Quek RG 2019. A systematic review of the international prevalence of BRCA mutation in breast cancer. Clin. Epidemiol. 11:543–61
    [Google Scholar]
  8. 10. 
    Bar-Sade RB, Kruglikova A, Modan B, Gak E, Hirsh-Yechezkel G et al. 1998. The 185delAG BRCA1 mutation originated before the dispersion of Jews in the diaspora and is not limited to Ashkenazim. Hum. Mol. Genet. 7:801–5
    [Google Scholar]
  9. 11. 
    Bar-Sade RB, Theodor L, Gak E, Kruglikova A, Hirsch-Yechezkel G et al. 1997. Could the 185delAG BRCA1 mutation be an ancient Jewish mutation. Eur. J. Hum. Genet. 5:413–16
    [Google Scholar]
  10. 12. 
    Bashford MT, Kohlman W, Everett J, Parrott A, Pollin TI 2019. Addendum: a practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment. Genet. Med. 21:2844
    [Google Scholar]
  11. 13. 
    Beitsch PD, Whitworth PW, Hughes K, Patel R, Rosen B et al. 2019. Underdiagnosis of hereditary breast cancer: Are genetic testing guidelines a tool or an obstacle. J. Clin. Oncol. 37:453–60
    [Google Scholar]
  12. 14. 
    Berliner JL, Fay AM. 2007. Risk assessment and genetic counseling for hereditary breast and ovarian cancer: recommendations of the National Society of Genetic Counselors. J. Genet. Couns. 16:241–60
    [Google Scholar]
  13. 15. 
    Bernhardt BA, Biesecker BB, Mastromarino CL 2000. Goals, benefits, and outcomes of genetic counseling: client and genetic counselor assessment. Am. J. Med. Genet. 94:189–97
    [Google Scholar]
  14. 16. 
    Bloss CS, Schork NJ, Topol EJ 2011. Effect of direct-to-consumer genomewide profiling to assess disease risk. N. Engl. J. Med. 364:524–34
    [Google Scholar]
  15. 17. 
    Blyuss O, Burnell M, Ryan A, Gentry-Maharaj A, Marino IP et al. 2018. Comparison of longitudinal CA125 algorithms as a first-line screen for ovarian cancer in the general population. Clin. Cancer Res. 24:4726–33
    [Google Scholar]
  16. 18. 
    Brandberg Y, Sandelin K, Erikson S, Jurell G, Liljegren A et al. 2008. Psychological reactions, quality of life, and body image after bilateral prophylactic mastectomy in women at high risk for breast cancer: a prospective 1-year follow-up study. J. Clin. Oncol. 26:3943–49
    [Google Scholar]
  17. 19. 
    Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A 2018. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 68:394–424
    [Google Scholar]
  18. 20. 
    Broady KM, Ormond KE, Topol EJ, Schork NJ, Bloss CS 2018. Predictors of adverse psychological experiences surrounding genome-wide profiling for disease risk. J. Community Genet. 9:217–25
    [Google Scholar]
  19. 21. 
    Bubien V, Bonnet F, Brouste V, Hoppe S, Barouk-Simonet E et al. 2013. High cumulative risks of cancer in patients with PTEN hamartoma tumour syndrome. J. Med. Genet. 50:255–63
    [Google Scholar]
  20. 22. 
    Buchanan AH, Manickam K, Meyer MN, Wagner JK, Hallquist MLG et al. 2018. Early cancer diagnoses through BRCA1/2 screening of unselected adult biobank participants. Genet. Med. 20:554–58
    [Google Scholar]
  21. 23. 
    Buchanan AH, Rahm AK, Williams JL 2016. Alternate service delivery models in cancer genetic counseling: a mini-review. Front. Oncol. 6:120
    [Google Scholar]
  22. 24. 
    Casey MJ, Synder C, Bewtra C, Narod SA, Watson P, Lynch HT 2005. Intra-abdominal carcinomatosis after prophylactic oophorectomy in women of hereditary breast ovarian cancer syndrome kindreds associated with BRCA1 and BRCA2 mutations. Gynecol. Oncol. 97:457–67
    [Google Scholar]
  23. 25. 
    Chen S, Parmigiani G. 2007. Meta-analysis of BRCA1 and BRCA2 penetrance. J. Clin. Oncol. 25:1329–33
    [Google Scholar]
  24. 26. 
    Chubak J, Bogart A, Fuller S, Laing SS, Green BB 2013. Uptake and positive predictive value of fecal occult blood tests: a randomized controlled trial. Prev. Med. 57:671–78
    [Google Scholar]
  25. 27. 
    Claus EB, Risch N, Thompson WD 1991. Genetic analysis of breast cancer in the cancer and steroid hormone study. Am. J. Hum. Genet. 48:232–42
    [Google Scholar]
  26. 28. 
    Collins FS, Varmus H. 2015. A new initiative on precision medicine. N. Engl. J. Med. 372:793–95
    [Google Scholar]
  27. 29. 
    Colombo N, Huang G, Scambia G, Chalas E, Pignata S et al. 2018. Evaluation of a streamlined oncologist-led BRCA mutation testing and counseling model for patients with ovarian cancer. J. Clin. Oncol. 36:1300–7
    [Google Scholar]
  28. 30. 
    Comm. Genet 2019. ACOG Committee Opinion number 793: hereditary cancer syndromes and risk assessment. Obstet. Gynecol. 134:e143–49
    [Google Scholar]
  29. 31. 
    Couch FJ, Shimelis H, Hu C, Hart SN, Polley EC et al. 2017. Associations between cancer predisposition testing panel genes and breast cancer. JAMA Oncol 3:1190–96
    [Google Scholar]
  30. 32. 
    Cuzick J. 2017. Preventive therapy for cancer. Lancet Oncol 18:e472–82
    [Google Scholar]
  31. 33. 
    Del Corral GA, Wes AM, Fischer JP, Serletti JM, Wu LC 2015. Outcomes and cost analysis in high-risk patients undergoing simultaneous free flap breast reconstruction and gynecologic procedures. Ann. Plast. Surg. 75:534–38
    [Google Scholar]
  32. 34. 
    Domchek SM, Friebel TM, Singer CF, Evans DG, Lynch HT et al. 2010. Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. JAMA 304:967–75
    [Google Scholar]
  33. 35. 
    Easton DF, Pharoah PD, Antoniou AC, Tischkowitz M, Tavtigian SV et al. 2015. Gene-panel sequencing and the prediction of breast-cancer risk. N. Engl. J. Med. 372:2243–57
    [Google Scholar]
  34. 36. 
    Ellison G, Wallace A, Kohlmann A, Patton S 2017. A comparative study of germline BRCA1 and BRCA2 mutation screening methods in use in 20 European clinical diagnostic laboratories. Br. J. Cancer 117:710–16
    [Google Scholar]
  35. 37. 
    Eng C. 2001. PTEN hamartoma tumor syndrome. GeneReviews MP Adam, HH Ardinger, RA Pagon, SE Wallace, LJH Bean et al. Seattle: Univ. Wash https://www.ncbi.nlm.nih.gov/books/NBK1488
    [Google Scholar]
  36. 38. 
    eviQ 2019. Referral guidelines for breast cancer risk assessment and consideration of genetic testing. eviQ https://www.eviq.org.au/cancer-genetics/adult/referral-guidelines/1620-referral-guidelines-for-breast-cancer-risk-as
    [Google Scholar]
  37. 39. 
    Fakkert IE, Abma EM, Westrik IG, Lefrandt JD, Wolffenbuttel BH et al. 2015. Bone mineral density and fractures after risk-reducing salpingo-oophorectomy in women at increased risk for breast and ovarian cancer. Eur. J. Cancer 51:400–8
    [Google Scholar]
  38. 40. 
    Febbraro T, Robison K, Wilbur JS, Laprise J, Bregar A et al. 2015. Adherence patterns to National Comprehensive Cancer Network (NCCN) guidelines for referral to cancer genetic professionals. Gynecol. Oncol. 138:109–14
    [Google Scholar]
  39. 41. 
    Finch A, Beiner M, Lubinski J, Lynch HT, Moller P et al. 2006. Salpingo-oophorectomy and the risk of ovarian, fallopian tube, and peritoneal cancers in women with a BRCA1 or BRCA2 mutation. JAMA 296:185–92
    [Google Scholar]
  40. 42. 
    Finch A, Shaw P, Rosen B, Murphy J, Narod SA, Colgan TJ 2006. Clinical and pathologic findings of prophylactic salpingo-oophorectomies in 159 BRCA1 and BRCA2 carriers. Gynecol. Oncol. 100:58–64
    [Google Scholar]
  41. 43. 
    Finch AP, Lubinski J, Moller P, Singer CF, Karlan B et al. 2014. Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation. J. Clin. Oncol. 32:1547–53
    [Google Scholar]
  42. 44. 
    Forbes C, Fayter D, de Kock S, Quek RG 2019. A systematic review of international guidelines and recommendations for the genetic screening, diagnosis, genetic counseling, and treatment of BRCA-mutated breast cancer. Cancer Manag. Res. 11:2321–37
    [Google Scholar]
  43. 45. 
    Francke U, Dijamco C, Kiefer AK, Eriksson N, Moiseff B et al. 2013. Dealing with the unexpected: consumer responses to direct-access BRCA mutation testing. PeerJ 1:e8
    [Google Scholar]
  44. 46. 
    Frank TS, Deffenbaugh AM, Reid JE, Hulick M, Ward BE et al. 2002. Clinical characteristics of individuals with germline mutations in BRCA1 and BRCA2: analysis of 10,000 individuals. J. Clin. Oncol. 20:1480–90
    [Google Scholar]
  45. 47. 
    Friebel TM, Domchek SM, Rebbeck TR 2014. Modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers: systematic review and meta-analysis. J. Natl. Cancer Inst. 106:dju091
    [Google Scholar]
  46. 48. 
    Gaba F, Piek J, Menon U, Manchanda R 2019. Risk-reducing early salpingectomy and delayed oophorectomy as a two-staged alternative for primary prevention of ovarian cancer in women at increased risk: a commentary. BJOG 126:831–39
    [Google Scholar]
  47. 49. 
    Gabai-Kapara E, Lahad A, Kaufman B, Friedman E, Segev S et al. 2014. Population-based screening for breast and ovarian cancer risk due to BRCA1 and BRCA2. PNAS 111:14205–10
    [Google Scholar]
  48. 50. 
    Garcia C, Wendt J, Lyon L, Jones J, Littell RD et al. 2014. Risk management options elected by women after testing positive for a BRCA mutation. Gynecol. Oncol. 132:428–33
    [Google Scholar]
  49. 51. 
    Gayther SA, Mangion J, Russell P, Seal S, Barfoot R et al. 1997. Variation of risks of breast and ovarian cancer associated with different germline mutations of the BRCA2 gene. Nat. Genet. 15:103–5
    [Google Scholar]
  50. 52. 
    George A, Riddell D, Seal S, Talukdar S, Mahamdallie S et al. 2016. Implementing rapid, robust, cost-effective, patient-centred, routine genetic testing in ovarian cancer patients. Sci. Rep. 6:29506
    [Google Scholar]
  51. 53. 
    Gill J, Obley AJ, Prasad V 2018. Direct-to-consumer genetic testing: the implications of the US FDA's first marketing authorization for BRCA mutation testing. JAMA 319:2377–78
    [Google Scholar]
  52. 54. 
    Gordhandas S, Norquist BM, Pennington KP, Yung RL, Laya MB, Swisher EM 2019. Hormone replacement therapy after risk reducing salpingo-oophorectomy in patients with BRCA1 or BRCA2 mutations; a systematic review of risks and benefits. Gynecol. Oncol. 153:192–200
    [Google Scholar]
  53. 55. 
    Gorski B, Jakubowska A, Huzarski T, Byrski T, Gronwald J et al. 2004. A high proportion of founder BRCA1 mutations in Polish breast cancer families. Int. J. Cancer 110:683–86
    [Google Scholar]
  54. 56. 
    Graham D, Schmool M, Waterman S 2007. Jews in Britain: a snapshot from the 2001 Census Rep., Inst. Jew. Policy Res London:
  55. 57. 
    Grann VR, Patel PR, Jacobson JS, Warner E, Heitjan DF et al. 2011. Comparative effectiveness of screening and prevention strategies among BRCA1/2-affected mutation carriers. Breast Cancer Res. Treat. 125:837–47
    [Google Scholar]
  56. 58. 
    Gray SW, Gollust SE, Carere DA, Chen CA, Cronin A et al. 2017. Personal genomic testing for cancer risk: results from the Impact of Personal Genomics Study. J. Clin. Oncol. 35:636–44
    [Google Scholar]
  57. 59. 
    Green RC, Berg JS, Grody WW, Kalia SS, Korf BR et al. 2013. ACMG recommendations for reporting of incidental findings in clinical exome and genome sequencing. Genet. Med. 15:565–74
    [Google Scholar]
  58. 60. 
    Green RF, Ari M, Kolor K, Dotson WD, Bowen S et al. 2019. Evaluating the role of public health in implementation of genomics-related recommendations: a case study of hereditary cancers using the CDC Science Impact Framework. Genet. Med. 21:28–37
    [Google Scholar]
  59. 61. 
    Hallowell N, Wright S, Stirling D, Gourley C, Young O, Porteous M 2019. Moving into the mainstream: healthcare professionals’ views of implementing treatment focussed genetic testing in breast cancer care. Fam. Cancer 18:293–301
    [Google Scholar]
  60. 62. 
    Hamilton JG, Abdiwahab E, Edwards HM, Fang ML, Jdayani A, Breslau ES 2017. Primary care providers’ cancer genetic testing-related knowledge, attitudes, and communication behaviors: a systematic review and research agenda. J. Gen. Intern. Med. 32:315–24
    [Google Scholar]
  61. 63. 
    Hampel H, Bennett RL, Buchanan A, Pearlman R, Wiesner GL 2015. A practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment. Genet. Med. 17:70–87
    [Google Scholar]
  62. 64. 
    Heemskerk-Gerritsen BAM, Jager A, Koppert LB, Obdeijn AI, Collee M et al. 2019. Survival after bilateral risk-reducing mastectomy in healthy BRCA1 and BRCA2 mutation carriers. Breast Cancer Res. Treat. 177:723–33
    [Google Scholar]
  63. 65. 
    Heemskerk-Gerritsen BAM, Seynaeve C, van Asperen CJ, Ausems MG, Collee JM et al. 2015. Breast cancer risk after salpingo-oophorectomy in healthy BRCA1/2 mutation carriers: revisiting the evidence for risk reduction. J. Natl. Cancer Inst. 107:djv033
    [Google Scholar]
  64. 66. 
    Hirsh-Yechezkel G, Chetrit A, Lubin F, Friedman E, Peretz T et al. 2003. Population attributes affecting the prevalence of BRCA mutation carriers in epithelial ovarian cancer cases in Israel. Gynecol. Oncol. 89:494–98
    [Google Scholar]
  65. 67. 
    Hopper JL, Southey MC, Dite GS, Jolley DJ, Giles GG et al. 1999. Population-based estimate of the average age-specific cumulative risk of breast cancer for a defined set of protein-truncating mutations in BRCA1 and BRCA2. Australian Breast Cancer Family Study. Cancer Epidemiol. Biomark. Prev. 8:741–47
    [Google Scholar]
  66. 68. 
    Hughes KS. 2017. Genetic testing: What problem are we trying to solve?. J. Clin. Oncol. 35:3789–91
    [Google Scholar]
  67. 69. 
    Isern AE, Tengrup I, Loman N, Olsson H, Ringberg A 2008. Aesthetic outcome, patient satisfaction, and health-related quality of life in women at high risk undergoing prophylactic mastectomy and immediate breast reconstruction. J. Plast. Reconstr. Aesthet. Surg. 61:1177–87
    [Google Scholar]
  68. 70. 
    Jacobs C, Patch C, Michie S 2019. Communication about genetic testing with breast and ovarian cancer patients: a scoping review. Eur. J. Hum. Genet. 27:511–24
    [Google Scholar]
  69. 71. 
    Kalia SS, Adelman K, Bale SJ, Chung WK, Eng C et al. 2017. Recommendations for reporting of secondary findings in clinical exome and genome sequencing, 2016 update (ACMG SF v2.0): a policy statement of the American College of Medical Genetics and Genomics. Genet. Med. 19:249–55
    [Google Scholar]
  70. 72. 
    Karczewski KJ, Weisburd B, Thomas B, Solomonson M, Ruderfer DM et al. 2017. The ExAC browser: displaying reference data information from over 60 000 exomes. Nucleic Acids Res 45:D840–45
    [Google Scholar]
  71. 73. 
    Kauff ND, Domchek SM, Friebel TM, Robson ME, Lee J et al. 2008. Risk-reducing salpingo-oophorectomy for the prevention of BRCA1- and BRCA2-associated breast and gynecologic cancer: a multicenter, prospective study. J. Clin. Oncol. 26:1331–37
    [Google Scholar]
  72. 74. 
    Kauff ND, Satagopan JM, Robson ME, Scheuer L, Hensley M et al. 2002. Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation. N. Engl. J. Med. 346:1609–15
    [Google Scholar]
  73. 75. 
    Kaufman DJ, Bollinger JM, Dvoskin RL, Scott JA 2012. Risky business: risk perception and the use of medical services among customers of DTC personal genetic testing. J. Genet. Couns. 21:413–22
    [Google Scholar]
  74. 76. 
    Kaurah P, Huntsman DG. 2002. Hereditary diffuse gastric cancer. GeneReviews MP Adam, HH Ardinger, RA Pagon, SE Wallace, LJH Bean et al. Seattle: Univ. Wash https://www.ncbi.nlm.nih.gov/books/NBK1139
    [Google Scholar]
  75. 77. 
    Kaurah P, MacMillan A, Boyd N, Senz J, De Luca A et al. 2007. Founder and recurrent CDH1 mutations in families with hereditary diffuse gastric cancer. JAMA 297:2360–72
    [Google Scholar]
  76. 78. 
    Khoury MJ, McCabe LL, McCabe ER 2003. Population screening in the age of genomic medicine. N. Engl. J. Med. 348:50–58
    [Google Scholar]
  77. 79. 
    King MC, Levy-Lahad E, Lahad A 2014. Population-based screening for BRCA1 and BRCA2: 2014 Lasker Award. JAMA 312:1091–92
    [Google Scholar]
  78. 80. 
    King MC, Marks JH, Mandell JB 2003. Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2. Science 302:643–46
    [Google Scholar]
  79. 81. 
    Kuchenbaecker KB, Hopper JL, Barnes DR, Phillips KA, Mooij TM et al. 2017. Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA 317:2402–16
    [Google Scholar]
  80. 82. 
    Kuchenbaecker KB, McGuffog L, Barrowdale D, Lee A, Soucy P et al. 2017. Evaluation of polygenic risk scores for breast and ovarian cancer risk prediction in BRCA1 and BRCA2 mutation carriers. J. Natl. Cancer Inst. 109:djw302
    [Google Scholar]
  81. 83. 
    Kurian AW, Hughes E, Handorf EA, Gutin A, Allen B et al. 2017. Breast and ovarian cancer penetrance estimates derived from germline multiple-gene sequencing results in women. JCO Precis. Oncol. https://doi.org/10.1200/PO.16.00066
    [Crossref] [Google Scholar]
  82. 84. 
    Kurian AW, Ward KC, Howlader N, Deapen D, Hamilton AS et al. 2019. Genetic testing and results in a population-based cohort of breast cancer patients and ovarian cancer patients. J. Clin. Oncol. 37:1305–15
    [Google Scholar]
  83. 85. 
    Lacaze P, Tiller J, Bao Y, Riaz M, Winship I, Zhang L 2019. Response to Veenstra et al. Genet. Med. 21:2842–43
    [Google Scholar]
  84. 86. 
    Lancaster JM, Powell CB, Chen LM, Richardson DL 2015. Society of Gynecologic Oncology statement on risk assessment for inherited gynecologic cancer predispositions. Gynecol. Oncol. 136:3–7
    [Google Scholar]
  85. 87. 
    Landrum MJ, Lee JM, Riley GR, Jang W, Rubinstein WS et al. 2014. ClinVar: public archive of relationships among sequence variation and human phenotype. Nucleic Acids Research 42:D980–85
    [Google Scholar]
  86. 88. 
    Lee K, Seifert BA, Shimelis H, Ghosh R, Crowley SB et al. 2019. Clinical validity assessment of genes frequently tested on hereditary breast and ovarian cancer susceptibility sequencing panels. Genet. Med. 21:1497–506
    [Google Scholar]
  87. 89. 
    Lerman C, Lustbader E, Rimer B, Daly M, Miller S et al. 1995. Effects of individualized breast cancer risk counseling: a randomized trial. J. Natl. Cancer Inst. 87:286–92
    [Google Scholar]
  88. 90. 
    Lieberman S, Lahad A, Tomer A, Cohen C, Levy-Lahad E, Raz A 2017. Population screening for BRCA1/BRCA2 mutations: lessons from qualitative analysis of the screening experience. Genet. Med. 19:628–34
    [Google Scholar]
  89. 91. 
    Lieberman S, Tomer A, Ben-Chetrit A, Olsha O, Strano S et al. 2017. Population screening for BRCA1/BRCA2 founder mutations in Ashkenazi Jews: proactive recruitment compared with self-referral. Genet. Med. 19:754–62
    [Google Scholar]
  90. 92. 
    Lilyquist J, LaDuca H, Polley E, Davis BT, Shimelis H et al. 2017. Frequency of mutations in a large series of clinically ascertained ovarian cancer cases tested on multi-gene panels compared to reference controls. Gynecol. Oncol. 147:375–80
    [Google Scholar]
  91. 93. 
    Lincoln SE, Kobayashi Y, Anderson MJ, Yang S, Desmond AJ et al. 2015. A systematic comparison of traditional and multigene panel testing for hereditary breast and ovarian cancer genes in more than 1000 patients. J. Mol. Diagn. 17:533–44
    [Google Scholar]
  92. 94. 
    Llort G, Chirivella I, Morales R, Serrano R, Sanchez AB et al. 2015. SEOM clinical guidelines in hereditary breast and ovarian cancer. Clin. Transl. Oncol. 17:956–61
    [Google Scholar]
  93. 95. 
    Lord CJ, Ashworth A. 2017. PARP inhibitors: synthetic lethality in the clinic. Science 355:1152–58
    [Google Scholar]
  94. 96. 
    Madalinska JB, Hollenstein J, Bleiker E, van Beurden M, Valdimarsdottir HB et al. 2005. Quality-of-life effects of prophylactic salpingo-oophorectomy versus gynecologic screening among women at increased risk of hereditary ovarian cancer. J. Clin. Oncol. 23:6890–98
    [Google Scholar]
  95. 97. 
    Madalinska JB, van Beurden M, Bleiker EM, Valdimarsdottir HB, Hollenstein J et al. 2006. The impact of hormone replacement therapy on menopausal symptoms in younger high-risk women after prophylactic salpingo-oophorectomy. J. Clin. Oncol. 24:3576–82
    [Google Scholar]
  96. 98. 
    Mai PL, Best AF, Peters JA, DeCastro RM, Khincha PP et al. 2016. Risks of first and subsequent cancers among TP53 mutation carriers in the National Cancer Institute Li-Fraumeni syndrome cohort. Cancer 122:3673–81
    [Google Scholar]
  97. 99. 
    Manchanda R, Abdelraheim A, Johnson M, Rosenthal AN, Benjamin E et al. 2011. Outcome of risk-reducing salpingo-oophorectomy in BRCA carriers and women of unknown mutation status. BJOG 118:814–24
    [Google Scholar]
  98. 100. 
    Manchanda R, Blyuss O, Gaba F, Gordeev VS, Jacobs C et al. 2018. Current detection rates and time-to-detection of all identifiable BRCA carriers in the Greater London population. J. Med. Genet. 55:538–45
    [Google Scholar]
  99. 101. 
    Manchanda R, Burnell M, Abdelraheim A, Johnson M, Sharma A et al. 2012. Factors influencing uptake and timing of risk reducing salpingo-oophorectomy in women at risk of familial ovarian cancer: a competing risk time to event analysis. BJOG 119:527–36
    [Google Scholar]
  100. 102. 
    Manchanda R, Burnell M, Gaba F, Desai R, Wardle J et al. 2019. Randomised trial of population-based BRCA testing in Ashkenazi Jews: long-term outcomes. BJOG 127:364–75
    [Google Scholar]
  101. 103. 
    Manchanda R, Burnell M, Gaba F, Sanderson S, Loggenberg K et al. 2019. Attitude towards and factors affecting uptake of population-based BRCA testing in the Ashkenazi Jewish population: a cohort study. BJOG 126:784–94
    [Google Scholar]
  102. 104. 
    Manchanda R, Burnell M, Loggenberg K, Desai R, Wardle J et al. 2016. Cluster-randomised non-inferiority trial comparing DVD-assisted and traditional genetic counselling in systematic population testing for BRCA1/2 mutations. J. Med. Genet. 53:472–80
    [Google Scholar]
  103. 105. 
    Manchanda R, Legood R, Antoniou AC, Gordeev VS, Menon U 2016. Specifying the ovarian cancer risk threshold of ‘premenopausal risk-reducing salpingo-oophorectomy’ for ovarian cancer prevention: a cost-effectiveness analysis. J. Med. Genet. 53:591–99
    [Google Scholar]
  104. 106. 
    Manchanda R, Legood R, Burnell M, McGuire A, Raikou M et al. 2015. Cost-effectiveness of population screening for BRCA mutations in Ashkenazi Jewish women compared with family history-based testing. J. Natl. Cancer Inst. 107:dju380
    [Google Scholar]
  105. 107. 
    Manchanda R, Loggenberg K, Sanderson S, Burnell M, Wardle J et al. 2015. Population testing for cancer predisposing BRCA1/BRCA2 mutations in the Ashkenazi-Jewish community: a randomized controlled trial. J. Natl. Cancer Inst. 107:dju379
    [Google Scholar]
  106. 108. 
    Manchanda R, Patel S, Antoniou AC, Levy-Lahad E, Turnbull C et al. 2017. Cost-effectiveness of population based BRCA testing with varying Ashkenazi Jewish ancestry. Am. J. Obstet. Gynecol. 217:578e1–12
    [Google Scholar]
  107. 109. 
    Manchanda R, Patel S, Gordeev VS, Antoniou AC, Smith S et al. 2018. Cost-effectiveness of population-based BRCA1, BRCA2, RAD51C, RAD51D, BRIP1, PALB2 mutation testing in unselected general population women. J. Natl. Cancer Inst 110:714–25
    [Google Scholar]
  108. 110. 
    Manickam K, Buchanan AH, Schwartz MLB, Hallquist MLG, Williams JL et al. 2018. Exome sequencing-based screening for BRCA1/2 expected pathogenic variants among adult biobank participants. JAMA Netw. Open. 1:e182140
    [Google Scholar]
  109. 111. 
    Marchetti C, De Felice F, Palaia I, Perniola G, Musella A et al. 2014. Risk-reducing salpingo-oophorectomy: a meta-analysis on impact on ovarian cancer risk and all cause mortality in BRCA 1 and BRCA 2 mutation carriers. BMC Women's Health 14:150
    [Google Scholar]
  110. 112. 
    Mavaddat N, Peock S, Frost D, Ellis S, Platte R et al. 2013. Cancer risks for BRCA1 and BRCA2 mutation carriers: results from prospective analysis of EMBRACE. J. Natl. Cancer Inst. 105:812–22
    [Google Scholar]
  111. 113. 
    Maxwell KN, Domchek SM, Nathanson KL, Robson ME 2016. Population frequency of germline BRCA1/2 mutations. J. Clin. Oncol. 34:4183–85
    [Google Scholar]
  112. 114. 
    McCuaig JM, Armel SR, Care M, Volenik A, Kim RH, Metcalfe KA 2018. Next-generation service delivery: a scoping review of patient outcomes associated with alternative models of genetic counseling and genetic testing for hereditary cancer. Cancers 10:435
    [Google Scholar]
  113. 115. 
    McGarrity TJ, Amos CI, Baker MJ 2001. Peutz-Jeghers syndrome. GeneReviews MP Adam, HH Ardinger, RA Pagon, SE Wallace, LJH Bean et al. Seattle: Univ. Wash https://www.ncbi.nlm.nih.gov/books/NBK1266
    [Google Scholar]
  114. 116. 
    Medeiros F, Muto MG, Lee Y, Elvin JA, Callahan MJ et al. 2006. The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome. Am. J. Surg. Pathol. 30:230–36
    [Google Scholar]
  115. 117. 
    Menon U, Ryan A, Kalsi J, Gentry-Maharaj A, Dawnay A et al. 2015. Risk algorithm using serial biomarker measurements doubles the number of screen-detected cancers compared with a single-threshold rule in the United Kingdom Collaborative Trial of Ovarian Cancer Screening. J. Clin. Oncol. 33:2062–71
    [Google Scholar]
  116. 118. 
    Metcalfe KA, Birenbaum-Carmeli D, Lubinski J, Gronwald J, Lynch H et al. 2008. International variation in rates of uptake of preventive options in BRCA1 and BRCA2 mutation carriers. Int. J. Cancer 122:2017–22
    [Google Scholar]
  117. 119. 
    Metcalfe KA, Eisen A, Senter L, Armel S, Bordeleau L et al. 2019. International trends in the uptake of cancer risk reduction strategies in women with a BRCA1 or BRCA2 mutation.
    [Google Scholar]
  118. 120. 
    Metcalfe KA, Mian N, Enmore M, Poll A, Llacuachaqui M et al. 2012. Long-term follow-up of Jewish women with a BRCA1 and BRCA2 mutation who underwent population genetic screening. Breast Cancer Res. Treat. 133:735–40
    [Google Scholar]
  119. 121. 
    Metcalfe KA, Poll A, Llacuachaqui M, Nanda S, Tulman A et al. 2010. Patient satisfaction and cancer-related distress among unselected Jewish women undergoing genetic testing for BRCA1 and BRCA2. Clin. Genet 78:411–17
    [Google Scholar]
  120. 122. 
    Metcalfe KA, Poll A, Royer R, Llacuachaqui M, Tulman A et al. 2010. Screening for founder mutations in BRCA1 and BRCA2 in unselected Jewish women. J. Clin. Oncol. 28:387–91
    [Google Scholar]
  121. 123. 
    Mikat-Stevens NA, Larson IA, Tarini BA 2015. Primary-care providers’ perceived barriers to integration of genetics services: a systematic review of the literature. Genet. Med. 17:169–76
    [Google Scholar]
  122. 124. 
    Moller P, Hagen AI, Apold J, Maehle L, Clark N et al. 2007. Genetic epidemiology of BRCA mutations—family history detects less than 50% of the mutation carriers. Eur. J. Cancer 43:1713–17
    [Google Scholar]
  123. 125. 
    Moslehi R, Chu W, Karlan B, Fishman D, Risch H et al. 2000. BRCA1 and BRCA2 mutation analysis of 208 Ashkenazi Jewish women with ovarian cancer. Am. J. Hum. Genet. 66:1259–72
    [Google Scholar]
  124. 126. 
    Natl. Compr. Cancer Netw 2020. Guidelines for genetic/familial high-risk assessment: breast, ovarian, and pancreatic Version 1.2020. Available at https://www.nccn.org/professionals/physician_gls
  125. 127. 
    Natl. Inst. Health (NIH) 2020. What is precision medicine?. NIH Genetics Home Reference https://ghr.nlm.nih.gov/primer/precisionmedicine/definition
    [Google Scholar]
  126. 128. 
    Natl. Inst. Health Care Excell. (NICE) 2019. Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer. NICE https://www.nice.org.uk/guidance/cg164
    [Google Scholar]
  127. 129. 
    Nelson HD, Fu R, Goddard K, Mitchell JP, Okinaka-Hu L et al. 2013. Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer: systematic review to update the U.S. Preventive Services Task Force recommendation. Evid. Synth. 101 Agency Healthc. Res. Qual., US Dep. Health Hum. Serv Rockville, MD:
  128. 130. 
    Nelson HD, Fu R, Zakher B, Pappas M, McDonagh M 2019. Medication use for the risk reduction of primary breast cancer in women: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 322:868–86
    [Google Scholar]
  129. 131. 
    Nelson HD, Pappas M, Cantor A, Haney E, Holmes RE 2019. Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 322:666–85
    [Google Scholar]
  130. 132. 
    Norquist BM, Brady MF, Harrell MI, Walsh T, Lee MK et al. 2018. Mutations in homologous recombination genes and outcomes in ovarian carcinoma patients in GOG 218: an NRG Oncology/Gynecologic Oncology Group study. Clin. Cancer Res. 24:777–83
    [Google Scholar]
  131. 133. 
    Norquist BM, Harrell MI, Brady MF, Walsh T, Lee MK et al. 2016. Inherited mutations in women with ovarian carcinoma. JAMA Oncol 2:482–90
    [Google Scholar]
  132. 134. 
    Owens DK, Davidson KW, Krist AH, Barry MJ, Cabana M et al. 2019. Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer: US Preventive Services Task Force recommendation statement. JAMA 322:652–65
    [Google Scholar]
  133. 135. 
    Pal T, Lee JH, Besharat A, Thompson Z, Monteiro AN et al. 2014. Modes of delivery of genetic testing services and the uptake of cancer risk management strategies in BRCA1 and BRCA2 carriers. Clin. Genet. 85:49–53
    [Google Scholar]
  134. 136. 
    Paluch-Shimon S, Cardoso F, Sessa C, Balmana J, Cardoso MJ et al. 2016. Prevention and screening in BRCA mutation carriers and other breast/ovarian hereditary cancer syndromes: ESMO clinical practice guidelines for cancer prevention and screening. Ann. Oncol. 27:v103–10
    [Google Scholar]
  135. 137. 
    Parker WH, Feskanich D, Broder MS, Chang E, Shoupe D et al. 2013. Long-term mortality associated with oophorectomy compared with ovarian conservation in the nurses’ health study. Obstet. Gynecol. 121:709–16
    [Google Scholar]
  136. 138. 
    Patel S, Legood R, Evans DG, Turnbull C, Antoniou AC et al. 2018. Cost effectiveness of population based BRCA1 founder mutation testing in Sephardi Jewish women. Am. J. Obstet. Gynecol. 218:431.e1–12
    [Google Scholar]
  137. 139. 
    Pew Res. Cent 2013. A portrait of Jewish Americans: findings from a Pew Research Center survey of U.S. Jews. Rep., Pew Res. Cent. Washington, DC:
  138. 140. 
    Phillips KA, Trosman JR, Douglas MP 2019. Emergence of hybrid models of genetic testing beyond direct-to-consumer or traditional labs. JAMA 321:2403–4
    [Google Scholar]
  139. 141. 
    Powell CB. 2014. Risk reducing salpingo-oophorectomy for BRCA mutation carriers: twenty years later. Gynecol. Oncol. 132:261–63
    [Google Scholar]
  140. 142. 
    Prince AE, Berg JS, Evans JP, Jonas DE, Henderson G 2015. Genomic screening of the general adult population: key concepts for assessing net benefit with systematic evidence reviews. Genet. Med. 17:441–43
    [Google Scholar]
  141. 143. 
    Rahman B, Lanceley A, Kristeleit RS, Ledermann JA, Lockley M et al. 2019. Mainstreamed genetic testing for women with ovarian cancer: first-year experience. J. Med. Genet. 56:195–98
    [Google Scholar]
  142. 144. 
    Rebbeck TR. 2014. Precision prevention of cancer. Cancer Epidemiol. Biomark. Prev. 23:2713–15
    [Google Scholar]
  143. 145. 
    Rebbeck TR, Friebel T, Lynch HT, Neuhausen SL, van't Veer L et al. 2004. Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. J. Clin. Oncol. 22:1055–62
    [Google Scholar]
  144. 146. 
    Rebbeck TR, Kauff ND, Domchek SM 2009. Meta-analysis of risk reduction estimates associated with risk-reducing salpingo-oophorectomy in BRCA1 or BRCA2 mutation carriers. J. Natl. Cancer Inst. 101:80–87
    [Google Scholar]
  145. 147. 
    Rebbeck TR, Lynch HT, Neuhausen SL, Narod SA, van't Veer L et al. 2002. Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N. Engl. J. Med. 346:1616–22
    [Google Scholar]
  146. 148. 
    Rebbeck TR, Mitra N, Wan F, Sinilnikova OM, Healey S et al. 2015. Association of type and location of BRCA1 and BRCA2 mutations with risk of breast and ovarian cancer. JAMA 313:1347–61
    [Google Scholar]
  147. 149. 
    Rebelatto TF, Falavigna M, Pozzari M, Spada F, Cella CA et al. 2019. Should platinum-based chemotherapy be preferred for germline BReast CAncer genes (BRCA) 1 and 2-mutated pancreatic ductal adenocarcinoma (PDAC) patients? A systematic review and meta-analysis. Cancer Treat. Rev. 80:101895
    [Google Scholar]
  148. 150. 
    Reid RJ, McBride CM, Alford SH, Price C, Baxevanis AD et al. 2012. Association between health-service use and multiplex genetic testing. Genet. Med. 14:852–59
    [Google Scholar]
  149. 151. 
    Roa BB, Boyd AA, Volcik K, Richards CS 1996. Ashkenazi Jewish population frequencies for common mutations in BRCA1 and BRCA2. Nat. Genet 14:185–87
    [Google Scholar]
  150. 152. 
    Rocca WA, Bower JH, Maraganore DM, Ahlskog JE, Grossardt BR et al. 2007. Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. Neurology 69:1074–83
    [Google Scholar]
  151. 153. 
    Rosenthal AN, Fraser LSM, Manchanda R, Badman P, Philpott S et al. 2013. Results of annual screening in phase I of the United Kingdom familial ovarian cancer screening study highlight the need for strict adherence to screening schedule. J. Clin. Oncol. 31:49–57
    [Google Scholar]
  152. 154. 
    Rosenthal AN, Fraser LSM, Philpott S, Manchanda R, Burnell M et al. 2017. Evidence of stage shift in women diagnosed with ovarian cancer during phase II of the United Kingdom Familial Ovarian Cancer Screening Study. J. Clin. Oncol. 35:1411–20
    [Google Scholar]
  153. 155. 
    Rosenthal E, Moyes K, Arnell C, Evans B, Wenstrup RJ 2015. Incidence of BRCA1 and BRCA2 non-founder mutations in patients of Ashkenazi Jewish ancestry. Breast Cancer Res. Treat. 149:223–27
    [Google Scholar]
  154. 156. 
    Rubinstein WS, Jiang H, Dellefave L, Rademaker AW 2009. Cost-effectiveness of population-based BRCA1/2 testing and ovarian cancer prevention for Ashkenazi Jews: a call for dialogue. Genet. Med. 11:629–39
    [Google Scholar]
  155. 157. 
    Scheuner MT, Hamilton AB, Peredo J, Sale TJ, Austin C et al. 2014. A cancer genetics toolkit improves access to genetic services through documentation and use of the family history by primary-care clinicians. Genet. Med. 16:60–69
    [Google Scholar]
  156. 158. 
    Schneider K, Zelley K, Nichols KE, Garber J 1999. Li-Fraumeni syndrome. GeneReviews MP Adam, HH Ardinger, RA Pagon, SE Wallace, LJH Bean et al. Seattle: Univ. Wash https://www.ncbi.nlm.nih.gov/books/NBK1311
    [Google Scholar]
  157. 159. 
    Schwartz MLB, McCormick CZ, Lazzeri AL, Lindbuchler DM, Hallquist MLG et al. 2018. A model for genome-first care: returning secondary genomic findings to participants and their healthcare providers in a large research cohort. Am. J. Hum. Genet. 103:328–37
    [Google Scholar]
  158. 160. 
    Shirts BH, Casadei S, Jacobson AL, Lee MK, Gulsuner S et al. 2016. Improving performance of multigene panels for genomic analysis of cancer predisposition. Genet. Med. 18:974–81
    [Google Scholar]
  159. 161. 
    Shuster LT, Gostout BS, Grossardt BR, Rocca WA 2008. Prophylactic oophorectomy in premenopausal women and long-term health. Menopause Int 14:111–16
    [Google Scholar]
  160. 162. 
    Skates SJ, Greene MH, Buys SS, Mai PL, Brown P et al. 2017. Early detection of ovarian cancer using the risk of ovarian cancer algorithm with frequent CA125 testing in women at increased familial risk – combined results from two screening trials. Clin. Cancer Res. 23:3628–37
    [Google Scholar]
  161. 163. 
    Stearnes G, Nichols CB, Schofield L, O'Sullivan S, Pachter N, Cohen PA 2019. Uptake of testing for germline BRCA mutations in patients with non-mucinous epithelial ovarian cancers in Western Australia: a comparison of different genetic counseling methods. Int. J. Gynecol. Cancer 29:1038–42
    [Google Scholar]
  162. 164. 
    Stewart KFJ, Wesselius A, Schreurs MAC, Schols A, Zeegers MP 2018. Behavioural changes, sharing behaviour and psychological responses after receiving direct-to-consumer genetic test results: a systematic review and meta-analysis. J. Community Genet. 9:1–18
    [Google Scholar]
  163. 165. 
    Tan MH, Mester JL, Ngeow J, Rybicki LA, Orloff MS, Eng C 2012. Lifetime cancer risks in individuals with germline PTEN mutations. Clin. Cancer Res. 18:400–7
    [Google Scholar]
  164. 166. 
    Tandy-Connor S, Guiltinan J, Krempely K, LaDuca H, Reineke P et al. 2018. False-positive results released by direct-to-consumer genetic tests highlight the importance of clinical confirmation testing for appropriate patient care. Genet. Med. 20:1515–21
    [Google Scholar]
  165. 167. 
    Teerlink CC, Albright FS, Lins L, Cannon-Albright LA 2012. A comprehensive survey of cancer risks in extended families. Genet. Med. 14:107–14
    [Google Scholar]
  166. 168. 
    Thavaneswaran S, Rath E, Tucker K, Joshua AM, Hess D et al. 2019. Therapeutic implications of germline genetic findings in cancer. Nat. Rev. Clin. Oncol. 16:386–96
    [Google Scholar]
  167. 169. 
    Thompson ER, Rowley SM, Li N, McInerny S, Devereux L et al. 2016. Panel testing for familial breast cancer: calibrating the tension between research and clinical care. J. Clin. Oncol. 34:1455–59
    [Google Scholar]
  168. 170. 
    Tung N, Lin NU, Kidd J, Allen BA, Singh N et al. 2016. Frequency of germline mutations in 25 cancer susceptibility genes in a sequential series of patients with breast cancer. J. Clin. Oncol. 34:1460–68
    [Google Scholar]
  169. 171. 
    Turnbull C, Sud A, Houlston RS 2018. Cancer genetics, precision prevention and a call to action. Nat. Genet. 50:1212–18
    [Google Scholar]
  170. 172. 
    Uglanitsa N, Oszurek O, Uglanitsa K, Savonievich E, Lubinski J et al. 2010. The contribution of founder mutations in BRCA1 to breast cancer in Belarus. Clin. Genet. 78:377–80
    [Google Scholar]
  171. 173. 
    Univ. Sheffield 2019. FRAX® fracture risk assessment tool. University of Sheffield https://www.sheffield.ac.uk/FRAX
    [Google Scholar]
  172. 174. 
    Vayena E. 2015. Direct-to-consumer genomics on the scales of autonomy. J. Med. Ethics 41:310–14
    [Google Scholar]
  173. 175. 
    Venkitaraman AR. 2019. How do mutations affecting the breast cancer genes BRCA1 and BRCA2 cause cancer susceptibility. DNA Repair 81:102668
    [Google Scholar]
  174. 176. 
    Vogel VG, Costantino JP, Wickerham DL, Cronin WM, Cecchini RS et al. 2010. Update of the National Surgical Adjuvant Breast and Bowel Project Study of Tamoxifen and Raloxifene (STAR) P-2 trial: preventing breast cancer. Cancer Prev. Res. 3:696–706
    [Google Scholar]
  175. 177. 
    Walsh T, Casadei S, Lee MK, Pennil CC, Nord AS et al. 2011. Mutations in 12 genes for inherited ovarian, fallopian tube, and peritoneal carcinoma identified by massively parallel sequencing. PNAS 108:18032–37
    [Google Scholar]
  176. 178. 
    Walsh T, Mandell JB, Norquist BM, Casadei S, Gulsuner S et al. 2017. Genetic predisposition to breast cancer due to mutations other than BRCA1 and BRCA2 founder alleles among Ashkenazi Jewish women. JAMA Oncol 3:1647–53
    [Google Scholar]
  177. 179. 
    Wasteson E, Sandelin K, Brandberg Y, Wickman M, Arver B 2011. High satisfaction rate ten years after bilateral prophylactic mastectomy – a longitudinal study. Eur. J. Cancer Care 20:508–13
    [Google Scholar]
  178. 180. 
    Weitzel JN, Lagos VI, Cullinane CA, Gambol PJ, Culver JO et al. 2007. Limited family structure and BRCA gene mutation status in single cases of breast cancer. JAMA 297:2587–95
    [Google Scholar]
  179. 181. 
    Wiesman C, Rose E, Grant A, Zimilover A, Klugman S, Schreiber-Agus N 2017. Experiences from a pilot program bringing BRCA1/2 genetic screening to the US Ashkenazi Jewish population. Genet. Med. 19:529–36
    [Google Scholar]
  180. 182. 
    Wilkes MS, Day FC, Fancher TL, McDermott H, Lehman E et al. 2017. Increasing confidence and changing behaviors in primary care providers engaged in genetic counselling. BMC Med. Educ. 17:163
    [Google Scholar]
  181. 183. 
    Wilson JMG, Jungner G. 1968. Principles and Practice of Screening for Disease Geneva: World Health Organ.
  182. 184. 
    Xicola RM, Li S, Rodriguez N, Reinecke P, Karam R et al. 2019. Clinical features and cancer risk in families with pathogenic CDH1 variants irrespective of clinical criteria. J. Med. Genet. 56:838–43
    [Google Scholar]
  183. 185. 
    Yang X, Leslie G, Doroszuk A, Schneider S, Allen J et al. 2020. Cancer risks associated with germline PALB2 pathogenic variants: an international study of 524 families. J. Clin. Oncol. 38:674–85
    [Google Scholar]
  184. 186. 
    Zhang L, Bao Y, Riaz M, Tiller J, Liew D et al. 2019. Population genomic screening of all young adults in a health-care system: a cost-effectiveness analysis. Genet. Med. 21:1958–68
    [Google Scholar]
  185. 187. 
    Zhang S, Royer R, Li S, McLaughlin JR, Rosen B et al. 2011. Frequencies of BRCA1 and BRCA2 mutations among 1,342 unselected patients with invasive ovarian cancer. Gynecol. Oncol. 121:353–57
    [Google Scholar]
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