Current estimates suggest that up to 3% of individuals who test positive on a multigene cancer test have more than one pathogenic finding, and our frequency of 3.1% is consistent with these estimates.1,2,30 In our population, a second positive variant would have been missed in 23 of 28 patients if individuals had been tested only for established high-penetrance genes such as BRCA1/2 or the Lynch syndrome genes. The gene discussed is BRCA1; the disease is Lynch syndrome.