{"entity":{"id":"paper-bedrosian-asco-sso-germline-testing-breast-jco-2024","kind":"paper","name":"Germline testing in patients with breast cancer: ASCO-Society of Surgical Oncology guideline","aka":[],"tldr":"The 2024 American guideline says every woman diagnosed with breast cancer at 65 or under should be offered BRCA1/2 testing, as should anyone who might be treated with a PARP inhibitor, whatever her family history.","summary":"An ASCO-SSO panel developed recommendations from a systematic review (47 articles on testing, 18 on counselling) and formal consensus. BRCA1/2 testing should be offered to all newly diagnosed patients at 65 or under and to selected older patients based on personal or family history, ancestry or PARP inhibitor eligibility; to all patients with recurrent breast cancer who are PARP inhibitor candidates regardless of family history; to women with a second primary in either breast; and to previously treated patients diagnosed at 65 or under. Testing beyond BRCA1/2 for high-penetrance genes should follow supportive family history, and moderate-penetrance testing may be offered to inform risk. Variants of uncertain significance should not change management.","asOf":"2026-09-24","links":[{"label":"Bedrosian et al., J Clin Oncol 2024: ASCO-SSO guideline on germline testing in breast cancer","url":"https://doi.org/10.1200/JCO.23.02225"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/38175972/"},{"label":"ASCO breast cancer guidelines","url":"https://ascopubs.org/topics/asco-guidelines/breast-cancer"}],"tags":[],"related":[],"cancers":["tnbc","breast-cancer"],"sections":[],"technologies":["germline-testing"],"targets":["brca"],"drugs":["olaparib","talazoparib"],"companies":[],"institutions":[],"pathways":[],"terms":["gbrca-mutation","vus","germline-vs-somatic"],"trials":[],"people":["giuseppe-curigliano"],"bottlenecks":[],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2024,"doi":"10.1200/JCO.23.02225","pmid":"38175972","authors":"Bedrosian I, Somerfield MR, Achatz MI, et al.","paperType":"guideline","findings":["BRCA1/2 testing for all patients diagnosed at 65 or under, and for any PARP inhibitor candidate.","Testing for a second primary breast cancer and for previously treated patients diagnosed at 65 or under.","Variants of uncertain significance should not alter management."],"whatItMeans":"For TNBC, which is diagnosed young and is the PARP inhibitor-eligible subtype, the guideline makes germline testing part of the diagnostic workup rather than a referral decision.","caveats":["United States guideline; NHS eligibility runs through the National Genomic Test Directory R208 criteria.","Population testing beyond age 65 was not endorsed."],"changedPractice":true},"route":"/key-papers/paper-bedrosian-asco-sso-germline-testing-breast-jco-2024/","neighbours":{"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"germline-testing","kind":"technology","name":"Germline (hereditary) testing","route":"/technologies/germline-testing/"}],"target":[{"id":"brca","kind":"target","name":"BRCA1 / BRCA2 (HRD)","route":"/targets/brca/"}],"drug":[{"id":"olaparib","kind":"drug","name":"Olaparib","route":"/drugs/olaparib/"},{"id":"talazoparib","kind":"drug","name":"Talazoparib","route":"/drugs/talazoparib/"}],"term":[{"id":"gbrca-mutation","kind":"term","name":"Germline BRCA mutation (gBRCA)","route":"/terms/gbrca-mutation/"},{"id":"germline-vs-somatic","kind":"term","name":"Germline vs somatic mutations","route":"/terms/germline-vs-somatic/"},{"id":"vus","kind":"term","name":"Variant of uncertain significance (VUS)","route":"/terms/vus/"}],"person":[{"id":"giuseppe-curigliano","kind":"person","name":"Giuseppe Curigliano","route":"/people/giuseppe-curigliano/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}],"biomarker":[{"id":"brca-germline","kind":"biomarker","name":"Germline BRCA1/2 pathogenic variant (gBRCAm)","route":"/biomarkers/brca-germline/"}]}}