Familial breast cancer

Introduction to project

This project uses software to calculate the risk of familial breast cancer for patients seen in primary care.

The project aims to increase advice around familial breast cancer, increase identification of individuals with a possible moderate to high familial risk of breast cancer, and to refer them for further screening and treatment as appropriate.

What is the condition?  

Risk of familial breast cancer (preventative care)

What are we doing? 

We have been working with a large Midlands primary care network (PCN) to pilot this project. Primary care plays a vital role in improving equity of access to familial cancer specialist services. Through this project, a nurse and GP within the PCN were trained with foundation knowledge of genomics to deliver this care.

A risk-reading software (FaHRAS) has been implemented at the Midlands PCN and patients invited to the project. The patients must complete a family history questionnaire which feeds into the FaHRAS system. FaHRAS generates a recommendation based on NICE guidelines, reporting whether patient is of population or increased risk, and this recommendation is checked by the trained nurse or GP. 

Any patients identified as of increased risk in primary care are referred to a family history clinic in secondary care where further risk stratification takes place. Dependent on the risk and age, the patient may be offered screening and chemoprevention at this clinic. A referral to genetics may also be appropriate.

What training is available?

Royal College of General Practitioners Webinars on Family History of Cancer and Rare Disease in Primary Care: Genomics Webinars (rcgp.org.uk). RCGP Genomics Webinar Part 1: Familial Cancer

BRCA-Direct Videos:

Patient-facing: https://www.youtube.com/watch?v=jqtoUAIhFhU

Health Care Professionals: https://www.youtube.com/watch?v=AI6YCugK6Fk

FutureLearn: Genomic Scenarios in Primary Care – Healthcare Course – FutureLearn

GeNotes: Presentation: Patient with a family history of breast cancer — In the Clinic (hee.nhs.uk)National Online training for healthcare professionals:  https://rmpartners.nhs.uk/lynch-syndrome-early-diagnosis-pathway-colorectal-cancer/

Online Training for Endometrial Cancer MDT’s: https://rmpartners.nhs.uk/lynch-syndrome-early-diagnosis-pathway-endometrial/

Online training for Pathologists: https://rmpartners.nhs.uk/lynch-syndrome-online-training-for-pathologists/

Online Training for Primary Care Clinicians: https://rmpartners.nhs.uk/lynch-syndrome-online-training-for-primary-care-clinicians/

Where can I find out more?

FaHRAS – Primary Care for GPs – FaHRAS

Who can I contact?

Lisa Dew

Donna Gillen