Page 9 - PRESENTATION

NCCN Guidelines Version 2.2020

Initial Prostate Cancer Diagnosis

Genetic counseling
Family history of to review the need

high-risk germline Germline mutation for additional
• Perform DRE to mutations (eg, not identified testing, if testing

confirm clinical stage BRCA1/2, Lynch based on family

• Perform and/or mutation) Germline testing c history
preferably with
collect PSAs and and/or

calculate PSA density Family history is pre-test genetic
counseling
and PSADT suspicious c
and/or Germline mutation
• Obtain and review Genetic counseling

diagnostic prostate Presence of identified
biopsies intraductal/cribriform
histology
• Estimate life

expectancy (See
Principles of Life

Expectancy Family history is

Estimation [PROS-A]) unknown or not NCCN guidelines suggest germline testing based on

• Inquire about known significant clinical features.

high-risk germline and

mutations c No However, in the Canadian context, germline testing is
intraductal/cribriform only done in cases where there is strong family
• Obtain family history c
histology
history or in a very young patient.

10 NCCN Clinical Practice Guidelines in Oncology Prostate Cancer Version 2.2020