Establishing a Family Risk Assessment Clinic for Breast Cancer
Article first published online: 22 SEP 2009
© 2009 Wiley Periodicals, Inc.
The Breast Journal
Volume 15, Issue Supplement s1, pages S33–S38, September/October 2009
How to Cite
Mulsow, J., Lee, J., Dempsey, C., Rothwell, J. and Geraghty, J. G. (2009), Establishing a Family Risk Assessment Clinic for Breast Cancer. The Breast Journal, 15: S33–S38. doi: 10.1111/j.1524-4741.2009.00825.x
- Issue published online: 22 SEP 2009
- Article first published online: 22 SEP 2009
- breast cancer;
- family history;
- genetic testing;
Abstract: Breast cancer is the most common cancer affecting European women and the leading cause of cancer-related death. A total of 15–20% of women who develop breast cancer have a family history and 5–10% a true genetic predisposition. The identification and screening of women at increased risk may allow early detection of breast cancer and improve prognosis. We established a family risk assessment clinic in May 2005 to assess and counsel women with a family history of breast cancer, to initiate surveillance, and to offer risk-reducing strategies for selected high-risk patients. Patients at medium or high risk of developing breast cancer according to NICE guidelines were accepted. Family history was determined by structured questionnaire and interview. Lifetime risk of developing breast cancer was calculated using Claus and Tyrer-Cuzick scoring. Risk of carrying a breast cancer-related gene mutation was calculated using the Manchester system. One thousand two hundred and forty-three patients have been referred. Ninety-two percent were at medium or high risk of developing breast cancer. Formal assessment of risk has been performed in 368 patients, 73% have a high lifetime risk of developing breast cancer, and 72% a Manchester score ≥16. BRCA1/2 mutations have been identified in 14 patients and breast cancer diagnosed in two. Our initial experience of family risk assessment has shown there to be a significant demand for this service. Identification of patients at increased risk of developing breast cancer allows us to provide individuals with accurate risk profiles, and enables patients to make informed choices regarding their follow-up and management.