When to Refer

The majority of individuals do not have family histories that are suggestive of a hereditary cancer predisposition. The following guidelines may help practitioners and patients determine who should seek cancer genetic counseling services.

There are several features of a family history that should raise the suspicion of a hereditary breast or ovarian cancer syndrome:

  • A personal or family history of early-onset breast cancer (<45)
  • A personal or family history of ovarian cancer at any age
  • A personal history of two or more breast cancers
  • A personal history of breast and ovarian cancer
  • A personal history of breast cancer at any age and at least one close family member with breast or ovarian cancer
  • A family history of two or more close family members with breast or ovarian cancer

There are several features of a family history that should raise the suspicion of a hereditary colon cancer syndrome:

  • A personal or family history of colon cancer diagnosed at an unusually young age (<50 years)
  • A personal or family history of colonic polyps diagnosed at an unusually young age (<45 years) or in large numbers (>10 polyps)
  • The presence of distinctive extra-colonic cancers, such as uterine cancer and colon cancer, in a family
  • To request an appointment with a genetic counselor in the Familial Cancer Risk Assessment Center, please call 781-744-3982.