Table 1.

Treatment focused genetic counseling indications

Clinical Indication	Factor(s) necessitating change	GC role/HCP role	GC Method	GC Service delivery
Prophylactic mastectomy	Personalized medicine and targeted therapy	GC liaison between patient and treating med oncologist	Targeted pre-test counseling session and thorough post test counseling (with medical oncologist input)	In person, phone, web-based
PARP-Inhibitor/Triple negative breast cancer	Patient awareness and advocacy; Direct to physician marketing of genetic based tests	GC liaison between patient and breast surgeon	Extensive pre-test counseling (ideally with psychologist/social work consultation) and post test counseling	In person with decision aid adjuncts