Beyond surgery, identification of patients with PGVs may lead to changes in medical and radiation oncology treatments that include the use of poly (ADP-ribose) polymerase (PARP) inhibitors for BRCA1/2-positive patients with high-risk, early-stage or metastatic disease, platinum-based chemotherapy for BRCA1/2-associated, metastatic, triple-negative disease, avoidance of RT in those with PGVs in TP53, and accelerated, partial, breast irradiation (APBI) in patients without PGVs in BRCA1/2. The gene discussed is BRCA1; the disease is metastatic neoplasm.