HNHB News

Helping patients facing a higher risk of breast cancer

How can we best help the one per cent of patients facing a higher risk for breast cancer? The Ontario Breast Screening Program Guidelines Summary includes screening information for women at high risk.

Who’s eligible? (Women 30 – 69)

Category A: These women are eligible for direct entry into the high-risk breast screening program based on personal and family history, and must meet one of the following risk criteria:

  • Known to be a carrier of the BRCA1 or BCRA2 gene mutation
  • First-degree relative of a mutation carrier who has had genetic counselling and declined genetic testing.
  • Previously assessed by a genetic clinic (using the IBIS or BOADICEA tools) as having a ≥25 per cent personal lifetime risk of breast cancer based on family history; or
  • Received radiation therapy to the chest before age 30 and at least eight years ago.

Category B: Genetic assessment required to determine eligibility for high risk breast screening and must meet one of the following risk criteria:

  • First-degree relative of a carrier of the BRCA1 or BRCA2 gene mutation and has not had genetic counselling or genetic testing; or
  • Personal or family history of breast or ovarian cancer suggestive of a hereditary breast cancer syndrome.

Here’s the OBSP Requisition for High Risk Screening. When it’s still difficult to tell, I call the program directly and they assess the individual situation.

For women who do not meet the criteria for the high risk program, the following pathways are suggested:

  • > 50-year-old women with a relative who had breast cancer under age 50, can do annual screening at an OBSP location without a requisition.
  • < 50-year-old women can be referred to genetics for testing.

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