1. Breast Cancer BRCA testing protocol
Patient with breast cancer – diagnosed < age 30 OR bilateral breast cancer both diagnosed < age 50 OR triple negative BrCa diagnosed < age 50 OR diagnosis of breast and ovarian cancer (any age).
Patient identified at Breast Cancer MDT – referral form completed - sent to FCS
Patient seen by clinician & patient told that FCS will be in touch to arrange an appt within 1-2 weeks.
NB : Any patients diagnosed in past but currently well can also be referred but will be offered an appt within more routine time frame (~8weeks)
MDT clinical team
Appointment with FCS team (within 1-2 weeks)
BRCA gene testing discussed. Implications for patient & family
Consent obtained and filed in the notes.
Blood (EDTA sample) and request form sent to lab.
Brief family history taken but history sheet given to patient to get more details about relatives
Follow up results appt booked to see FCS in 12 weeks
More discussion required
Refer to Genetics
Genetic test results sent to the Familial Cancer team within weeks
Results forwarded to MDT
Familial Cancer Team at Royal Derby Hospital
NO MUTATION
MUTATION
UNCLASSIFIED VARIANT
Follow up appt in FCS
Results given in person to patient
Confirm family history
Advice about other cancer risks for patient & family . TWIMC letter
Results copied to GP & relevant clinicians
Follow up appt in FCS
Results given in person to patient
Confirm family history
Advice about other cancer risks for patient & family.
Results copied to GP & relevant clinicians
Follow up appt in FCS
Results given in person to patient
Confirm family history
Advice about other cancer risk for patient & family.
Results copied to GP & relevant clinicians
Referral made to clinical genetics if complex family history & need to consider other genes/BOCS or any women dx Brca aged <30
A clinical genetics appointment or telephone contact will be arranged within 4 weeks (mutation +ve women) or 12 weeks (VUS & relevant mutation-ve women) of receiving the referral
Genetics Team