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Since the identification of germline mutations in BRCA1 and BRCA2, there has been continuous evolution in the identification of additional susceptibility germline mutations that increase risk for breast cancer and other malignancies. With the application of next-generation sequencing, not only has the pace of discovery accelerated in the past decade but this has occurred at a considerable reduction in cost. Thus, physicians are now faced with the challenge of how to appropriately integrate this rapidly expanding information into daily practice. Although existing guidelines and recommendations have focused on the management of future cancer risk associated with germline mutations as well as surveillance and prevention strategies, guidance on the management of patients with germline mutations and newly diagnosed breast cancer has not kept up with the rapid pace of discovery. In 2018, the Society of Surgical Oncology (SSO) entered into an agreement with the American Society of Clinical Oncology (ASCO) and the American Society of Radiation Oncology (ASTRO) to develop a guideline on the management of hereditary breast cancer. Four SSO members, specializing in breast surgical oncology, were appointed to the expert panel developing the guideline. The recommendations within the consensus guideline were reviewed and voted on by more than 50 individuals. Additionally, the recommendations were posted for public comment. SSO Quality Committee Chair, Tari King, MD reviewed the final document and recommended that the SSO proceed with approval of the recommendations; consequently, the SSO leadership agreed that the society approve the guidelines. In this editorial, we summarize and comment on the ASCO, ASTRO, and SSO Guideline on the Management of Hereditary Breast Cancer, published in this issue of the Annals of Surgical Oncology. The expert panel’s recommendations focused on the surgical management of patients with breast cancer and germline mutations, as well as on the use of radiation therapy and systemic therapy for such patients.

Management of Hereditary Breast Cancer: ASCO, ASTRO, and SSO Guideline