"We're not doing as good a job as we should be," Kaklamani said. "We don't ask that [family history] over and over again. That is both the doctor's and patient's fault."
Kaklamani said guidelines -- there are several different versions by various medical organizations including the National Comprehensive Cancer Network -- are published every year for doctors to learn and use.
But "everybody's so busy," she said. "I don't think physicians are as aware of guidelines. They need to learn so many things. People are not going to go to a genetics conference."
Beth N. Peshkin, a senior genetic counselor at Georgetown Lombardi Cancer Center, said it was reasonable to believe that doctors should adapt.
"These [BRCA] genes were identified in 1994 and 1995 and guidelines have been around for years," she said. "This study is a wakeup call to get the message out and educate physicians so they have in their arsenal the knowledge and confidence" to assess risk.
"At the end of the day, you have to be your very own advocate," Trivers said.