Thumbs down.

The always cost-conscious USPTSF responded with a failing grade to breast surgeons going rogue with their catch-all genetic counseling recs. They tone it way down by recommending screening only those with an ethnicity associated with or an actual family history of BRCA mutation. What’s more, by screening they don’t mean testing. Screening means simply asking questions, and fortunately they provide structured tools with scoring systems that pretty much anyone can decipher. Only if someone screens positive does the USPTSF support referral to a genetic counselor who then may or may not recommend the actual genetic testing (read: the expensive part). TBL: Genetic testing—or even counseling or screening!—women for BRCA mutations without high-risk ancestry or family history gets a hard D from the USPSTF. | Herman, NEJM Journal watch 2019


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