Additional guidance pertaining to cancer risk management was provided in the most recent version of the NCCN Guidelines for inherited breast and ovarian cancer. These guidelines now include an expanded table outlining cancer risks and management for each gene, taking into account the age at initiation of each risk management modality as well as footnotes to highlight some of the nuances concerning particular mutations in specific genes. For example, among ATM and CHEK2 carriers, recommended age at initiation of high-risk breast screening with breast MRI is 40 years. Furthermore, the higher breast cancer risks associated with the ATM 7271T>G missense mutation is included as a footnote, as is the fact that the data on increased breast cancer risks associated with NBN is almost solely derived from the 657del5 truncating mutation. The full guidelines may be accessed through the NCCN website (www.nccn.org).
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