Jame Abraham, Chairman and Professor at the Department of Hematology and Medical Oncology at Cleveland Clinic, shared a post on LinkedIn:
“When should we consider germline genetic testing in patients with cancer?
Key, guideline-supported indications
- Young age at cancer diagnosis
Cancer diagnosed at an unusually young age (often ≤50 years, depending on tumor type), regardless of family history. - Tumor types strongly associated with hereditary syndromes
Examples include:
• Breast, ovarian, pancreatic, prostate
• Colorectal and endometrial cancers
• Sarcomas, adrenal cortical carcinoma, and certain CNS tumors - Significant personal or family history of cancer
Cancer at any age plus:
• Multiple affected first- or second-degree relatives
• Early-onset cancers in the family
• Rare cancers or known pathogenic variants in relatives - Multiple primary cancers in the same individual
Including bilateral cancers or cancers across different organ systems suggestive of an inherited cancer syndrome. - Cancer in special populations or clinical contexts
• Male breast cancer
• High-risk ancestry (e.g., Ashkenazi Jewish ancestry)
• Tumor sequencing identifying a potential germline pathogenic variant
Bottom line:
Germline genetic testing informs treatment selection, cancer surveillance, risk-reduction strategies, and cascade testing for families—and should be considered an integral part of modern oncology.”
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