Tumor grade was the most important confounder in the multivariable model, with grade 3 being statistically significantly associated with higher RS and with PVs in BRCA1, BRCA2, and PALB2. The proportion of patients with RS of 26 or higher followed a similar pattern: for carriers of PVs in BRCA1, it was 71.7%, in PALB2 37.1%, and in BRCA2 44.3% compared with 14.4% among patients testing negative (P ≤.001 for each comparison Figure 1). This evidence concerns the gene PALB2 and neoplasm.