To our knowledge, our study is the first in a community hospital setting to offer a hybrid model that includes testing all breast cancer patients age 60 or younger or younger than 65 years, as advocated by Yadav et al.12 and Desai et al.11 Universal testing up to age 65 years or younger has been shown to increase the sensitivity for pathogenic variants in BRCA1 or BRCA2 to more than 98%.12 The expanded age criteria detected more than twice as many PV/LPVs in breast cancer-related genes (3.6% vs 1.6%) and 1.7 times as many PV/LPVs in any of the tested genes (5.4% vs.3.1%). This evidence concerns the gene BRCA1 and breast cancer.