Breast cancer is the most common cancer among women in Egypt and poses a growing public health challenge with significant socio-economic implications. While traditional diagnostic and treatment approaches remain central to care, advances in genetic testing offer new pathways for early detection, prevention and individualised treatment. Genetic testing, particularly for BRCA1, BRCA2 and other high-penetrance gene mutations, can identify women at elevated risk, enabling proactive surveillance, risk-reducing strategies and tailored therapeutic decisions. This article evaluates the cost-effectiveness of incorporating breast cancer genetic testing into national healthcare protocols. Evidence suggests that genetic screening for high-risk populations can significantly reduce long-term treatment costs by avoiding unnecessary interventions and improving survival through early detection and personalised therapy. In the Egyptian context, the upfront cost of testing can be offset by savings from more targeted chemotherapy, reduced recurrence rates and improved quality of life. The article further discusses the role of personalised medicine in transforming breast cancer care, emphasising the need for national policies that support equitable access to testing. It proposes practical guidelines, including risk-based screening criteria, integration of genetic counseling services, government-subsidised testing programs and capacity-building in local genomic laboratories. By adopting a structured, evidence-based approach to genetic testing and personalised care, Egypt can enhance treatment outcomes, reduce healthcare expenditures and align with global trends in precision oncology. The integration of genetic testing into routine oncology care not only supports clinical decision-making but also represents a strategic investment in the long-term sustainability and efficiency of Egypt’s healthcare system.