LAUSR

Key Points Question Is unselected genetic testing of all women with breast cancer cost-effective compared with testing based on clinical criteria or family history? Findings In this cost-effectiveness microsimulation modeling study incorporating data from 11 836 women, unselected BRCA1/BRCA2/PALB2 testing at breast cancer diagnosis was extremely cost-effective compared with BRCA1/BRCA2 testing based on clinical criteria or family history for UK and US health systems, with incremental cost-effectiveness ratios of £10 464 or £7216 and $65 661 or $61 618 per quality-adjusted life-year, respectively. One year’s unselected panel genetic testing could prevent 2101 cases of breast or ovarian cancer and 633 deaths in the United Kingdom and 9733 cases and 2406 deaths in the United States. Meaning These findings support changing current policy to expand genetic testing to all women with breast cancer.