|
FAMILY
HISTORY AND HIGH RISK CLINICS
Between
5-10% of patients with breast cancer have a genetic abnormality that predisposes
them to develop breast cancer. The following criteria should be used to
identify patients with breast cancer mutation:
1. Several cases of
breast cancer in a single family.
2. Early onset of breast cancer in affected relatives, especially premenopausal
breast cancer.
3. Presence of multiple epithelial cancers in family members including
bilateral breast cancer or ovarian cancer, colon and prostate cancer.
A combination of breast and ovarian cancers is particularly common in
families with a 'cancer genes'
Patients at high risk
of developing breast cancer should be managed with a well organised co-ordinated
approach. It has to be understood that all patients require early detection
of disease but psychological and genetic counselling forms important part
of their management. At present in our family history clinics annual clinical
assessment is provided to all patients who are under 60 years of age.
| Protocol
for Family History Clinics |
| Annual
clinical assessment |
Mammographic
screening |
Referral
for predictive gentic testing |
|
Less
than 60 yrs with a family history of one first or two or more second
degree relatives with breast cancer.
All
patients with anxiety and family history which may not be clinically
significant.
|
Screening
annually from age 35 with or without ultrasound :
A first degree relative with breast cancer < 40years.
Two relatives with breast cancer < 60years
Screening
two yearly from the age of 40:
All patients who are under 50 years and not eligible for National
Breast Screening programme but have a family history of breast cancer.
|
Patients
with at least one affected member still alive and willing to have
genetic screening to find alteration inthe family.
Four
cases of breast cancer under theage of 60 or 4 cases of breast and
ovarian cancer (ovarian at any age)
Ashkenazi
Jewish women under the age of 40 with or without family history
of breast cancer.
|
If
you require further advice or information please contact the
Macmillan Breast Care Nurses, Hazel Ricard and Hilary Rickwood on 020
8565 5885
|
