Fig. 1. Multiple steps need to be taken using family history (FH) guidelines.

There are many steps that need to be completed for an unaffected woman with a mutation in a BC susceptibility gene to receive BC genetic testing. These steps are outlined here, with data provided for both NHW and NHB women when available. Initially, let us assume an unaffected carrier meets cancer FH based criteria. The next step is that, she must be asked about her cancer FH by her health care provider (or volunteer the information). The health care provider must understand the current guidelines and either (a) recommend the woman for genetic counseling, (b) order the genetic test directly, or (c) decide that genetic testing is not needed (this branch is not shown). If a woman receives a recommendation for genetic counseling, she must then meet with the genetic counselor, undergo testing, and receive her results. Some of the articles cited above do not clarify if the participants are non-Hispanic. Abbreviations: NHW non-Hispanic white, NHB non-Hispanic black, FH family history.