BlueCross BlueShield of Tennessee Medical Policy Manual

Nonfamilial Genetic Testing for Breast Cancer Risk Assessment

Does Not Apply to Commercial Genetic Testing Program effective 6/1/2018


A number of single nucleotide variants (SNVs), which are single base-pair variations in the DNA sequence of the genome, have been associated with breast cancer and are common in the population, but confer only small increases in risk. Commercially available assays purportedly test for a number of SNVs and predict an individual’s risk of breast cancer relative to the general population. Some of these assays incorporate clinical information into risk prediction algorithms. The intent of this type of test is to identify subjects without a family history of breast cancer who may be at increased risk due to single nucleotide variants and may benefit from more intensive surveillance.

Examples of genetic testing assays for non-familial breast cancer risk assessment include but are not limited to BREVAGen and BREVAGenplus.

Note: This policy does not address testing for BRCA1, BRCA2, PALB2, TP53 or PTEN single gene variants associated with inherited breast cancer.




There is a lack of high-quality evidence to determine if SNV-based risk assessment has any impact on health care outcomes. The U.S. Preventive Services Task Force and American Cancer Society recommend mammography for breast cancer screening in average risk individuals.


American Cancer Society. (2017). American Cancer Society recommendations for the early detection of breast cancer. Retrieved November 29, 2017 from

BlueCross BlueShield Association. Evidence Positioning System. (10:2018). Use of common genetic variants (single nucleotide variants) to predict risk of nonfamilial breast cancer (2.04.63). Retrieved October 26, 2018 from (90 articles and/or guidelines reviewed)

McCarthy, A., Armstrong, K., Handorf, E., Jones, M., Chen, J., Demeter, M. B., (2013). Incremental impact of breast cancer SNP panel on risk classification in a screening population of white and African American women. Breast Cancer Research and Treatment, 138 (3), 889-898. (Level 2 evidence)

U.S. Preventive Service Task Force (February, 2016) Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Retrieved October 26, 2018 from

Young, M., Forrest, L., Rasmussen, V., James, P., Mitchell, G., Sawyer, S., et al. (2017). Making sense of SNPs: Women’s understanding and experiences of receiving a personalized profile of their breast cancer risks. Journal of Genetic Counseling, 2017 Nov 22. Doi: 10.1007/s10897-017-0162-z. [Epub ahead of print]. Abstract retrieved November 29, 2017 from PubMed database.




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