Genetic testing for cancer predisposition informs precision cancer prevention and care. Clear understanding and communication of the cancer risk associated with each identified gene variant underlies responsible decision-making. We describe an initiative promoted by the ENIGMA consortium that involved 70 scientists from 25 countries worldwide to harmonize reporting of germline genetic test results for breast cancer. We provide up-to-date recommendations in 21 languages, benefitting a potentially broad audience. Consistent communication of test-derived information will empower informed decisions and more coherent risk management, fostering prevention, early detection, improved outcomes, and greater equity in the use of genetic testing in oncology. (https://jmg.bmj.com/content/early/2026/05/14/jmg-2026-111498)