To overcome this issue, Siraj et al. designed the hereditary oncogenesis predisposition evaluation (HOPE) including genes with known association to breast cancer and other tumours in 1300 Arab cancer patients.92 Pathogenic or likely pathogenic alleles in genes other than BRCA2, ATM and PALB2 accounted for ~16.8% of mutation-positive breast cancers in which a family history was lacking in 63.7% of mutation-positive cases.92 This highlighted how germline mutations to breast cancer predisposition extend beyond the classic hereditary cancer genes. This evidence concerns the gene ATM and breast carcinoma.