A great success of modern human genetics is the identification of specific genes that, when altered, confer clinically recognized traits, such as cancer susceptibility, and enable predictive genetic testing. In past decades, cost and turn-around time limited cancer genetic risk assessment, and it was rarely feasible to test a patient for more than 1 well-defined condition (eg, hereditary breast ovarian cancer [HBOC] or Lynch syndrome). Transformative sequencing advances now permit massively parallel, rapid analysis of many genes, making the “$1000 genome” an imminent reality. In June 2013, long-term barriers to cancer genetic testing were breached by a remarkable convergence of events: the disclosure of her BRCA1 mutation by the actress Angelina Jolie, which dramatically increased public awareness and demand for genetic testing1; and the US Supreme Court decision against gene patenting, which allowed competition to reduce the price ofBRCA1 and BRCA2 (BRCA1/2) testing.2 Incentives quickly shifted toward sequencing more genes as laboratories competed to offer panels of increasing numbers of genes (from 6 to >100) at decreasing prices. Perhaps because testing costs have fallen so greatly, insurers rarely object to multigene panels as a means of diagnosing recognized syndromes (eg, HBOC) when relevant guidelines are met. However, most payers will not cover more than 1 cancer risk assessment test, creating an incentive to sequence any genes of interest concurrently rather than sequentially. In short, multigene panels have entered the clinic,3 and there seems little chance of forcing the genie back into the bottle.