The case for universal hereditary cancer genetic testing: Breast and ovarian cancer

As our understanding of cancer genetics continues to evolve, it’s becoming increasingly clear that universal hereditary cancer genetic testing can uncover critical information that shapes cancer care. For patients with breast and ovarian cancer, identifying inherited genetic variants not only informs treatment and therapeutic decisions, but also opens the door to preventive strategies and family risk assessment. 

Despite its proven benefits, many patients remain untested and miss opportunities for personalized care and early intervention.¹ This blog explores why universal hereditary cancer genetic testing is essential and how it can help transform outcomes for patients and their families. 

Breast cancer: Guidelines support testing universally  

Genetic testing is essential for patients with breast cancer—not just for understanding risk, but for helping to guide care. Consider these key facts: 

• 1 in 8 patients with breast cancer have an inherited gene variant associated with increased cancer risk^2,3   
• >75% of patients with breast cancer and an inherited cancer risk gene variant had changes to their clinical management⁴ 
• 73% of patients with breast cancer remain untested^1,5 

These numbers highlight a critical gap in care and an opportunity to improve outcomes. For patients with breast cancer, genetic testing is more than a diagnostic tool—it can help inform personalized care. Identifying inherited genetic variants like BRCA1 and BRCA2 can influence treatment decisions, such as surgical options and systemic therapies, and guide preventive strategies for future cancers.^2,4,6 It also empowers family members with knowledge about their own risk.² 

Given the clinical value of genetic test insights, the American Society of Breast Surgeons recommends offering hereditary cancer genetic testing to all patients with breast cancer.⁷   Universally testing patients with breast cancer is a critical step toward more informed, equitable, and effective cancer care. 

Ovarian cancer: Universal hereditary cancer genetic testing can help guide preventive care and targeted therapy  

Ovarian cancer is often diagnosed in later stages due to subtle or non-specific symptoms. Hereditary cancer genetic testing helps clinicians intervene earlier and tailor treatment more effectively. 

About 1 in 5 patients with ovarian cancer has a gene variant that increases cancer risk.^2,8,9 Even more striking: over 30% of women with disease-causing variants had no reported family history of breast or ovarian cancer, highlighting the importance of hereditary cancer genetic testing for all patients with ovarian cancer.⁸ 

For patients with genetic variants that increase cancer risk, clinical care can include^2,10:  

• Targeted therapies^11-13  
• PARP inhibitors, often used after platinum-based chemotherapy, are more effective in patients with BRCA1/2 or other homologous recombination repair (HRR) gene mutations. 
• These therapies can significantly improve progression-free survival in both frontline and recurrent settings. 
• Preventive surgeries  
• Results can guide decisions about risk-reducing surgeries (e.g., salpingo-oophorectomy). 
• Access to clinical trials  
• Family member testing and genetic counseling   
• Family members can undergo cascade testing to assess their own risk and take preventive steps. 

Why universal genetic testing makes sense in breast and ovarian cancer 

Universal hereditary cancer genetic testing empowers patients by supporting earlier detection, helping guide personalized treatment, and informing proactive risk-reduction steps. By identifying inherited cancer risks for all patients affected by cancer—not just those with a known family history—we can help close critical gaps in care, reduce disparities, and ensure that every patient has access to potentially life-saving information. It's a simple step with profound impact: better outcomes, informed decisions, and a future where fewer families face cancer unexpectedly. 

What oncologists can do 

• Offer testing early: Provide testing at diagnosis, when it can help influence treatment decisions. 
• Partner with genetic counselors: Ensure patients understand their results and next steps. 
• Educate your team: Make sure everyone—from nurses to navigators—knows the value of testing.

What patients should know 

Hereditary cancer genetic testing isn’t just about understanding your cancer—it’s about helping you find the best treatment and protecting your family. Even if no one else in your family has had cancer, you could still carry a genetic variant that matters.

From uncertainty to insight: The value of universal genetic testing 

Breast and ovarian cancer are complex, but hereditary cancer genetic testing can offer more clarity—helping oncologists deliver more targeted care and giving patients and families the information they need to make empowered decisions. 

If you’re an oncologist, it’s time to make genetic testing a routine part of your care strategy. 

If you’re a patient with breast or ovarian cancer, ask your doctor if testing is right for you—even if you don’t have a family history. To learn more about genetic testing watch our education video.