These observations reflect an ongoing challenge in cancer risk assessment for women with germline CDH1 P/LP variants: since individual CDH1 genetic testing criteria are largely centered around post hoc manifestations of disease (i.e., diffuse gastric cancer and/or lobular breast cancer), preemptive screening is almost entirely reliant on family history, which can be difficult to ascertain due to the rarity of CDH1 mutations, patient recall bias, and other factors8,17,18. This evidence concerns the gene CDH1 and cancer.