The first thing is when I see a patient who fits the criteria, meaning there are certain criteria we work by in our high-risk program. The criteria we use is based on the NCCN guidelines. That is the National Cancer Comprehensive Network. This is an organization that deals with all cancers, not just breast cancer, and basically the smartest people in the country, if you will, get together several times a year to come up with recommendations for the diagnosis, the treatment and how to handle different cancers. When I see a patient for the first time that maybe has never been diagnosed with cancer but she’s here to evaluate a breast lump or abnormal mammogram, part of our work up is inquiring about her own past history herself, her family history which is very important, to see is she a candidate for possibly undergoing a more full evaluation to see if she meets that criteria. One thing that is very important is that BRCA testing is not a screening tool. People shouldn’t walk in off the street and want that test. There is very strict criteria that should be met before they’re tested because only then do you know the implications it can have for that patient.
