A limitation of our study was that NOP Ver.1 lacked several important CSGs that are now considered actionable for breast and ovarian cancer in particular such as MSH6, PMS2, RAD51C and RAD51D, and NOP Ver.2 still did not include SDHB, SDHC, SDHD, and MUTYH, which were included in ACMG and ESMO recommendations (3, 10, 11, 14). The gene discussed is MSH6; the disease is ovarian cancer.