In a recent USPSTF statement [1], the task force recommended that women with a familial and potential genetic predisposition for BRCA1/2 gene mutations be tested and undergo genetic counseling. Multiple cancers, like many hyperlipidemias, are associated with genetic predispositions, including BRCA1/2, p53 and Lynch Syndrome [2]. However, these genetic predispositions toward transitional tissue changes do not mean cancer is destined to develop [3]. How do you counsel someone over what might happen, without knowing which environmental factors will set into motion Conflict of Interest FMTVDM patent was issued to first author.