AQW 6880/22-27
Ms Paula Bradshaw
Alliance Party
South Belfast
Tabled Date: 19/02/2024
Answered On Date: 05/03/2024
Priority Written: No
Question:
To ask the Minister of Health what steps he is taking to raise awareness of genetic tests to identify women who have most to benefit from preventative drugs which protect against breast cancer.
Answer:
The Regional Breast Cancer Family History Group developed patient resources with representatives across all Trusts including a patient representative. The group developed web and video presentations which included an ‘introduction to the family history resource’, an ‘overview of the breast family history clinic’ and information on the Regional Genetics Service at Belfast City Hospital. The history information and video resources were launched at the BRCA conference on 19th May 2023. All Trusts have these resources available on their websites, they are also available on the Northern Ireland Cancer website. Information for patients who may be eligible for genetic testing, along with information about genes such as BRCA1 and BRCA2, associated cancer risks and management options for women, is available on the Genetic Medicine Website. For families where there is a known inherited genetic change in a high-risk cancer gene, relatives can either request a referral from their GP or self-refer to the Cancer Genetics service to discuss genetic testing. Cascade family testing is offered to blood relatives of the index patient to identify those family members who have inherited the variant and are at a higher risk of developing breast, ovarian, and other cancers. This enables the establishment of preventive and surveillance measures such as risk-reducing mastectomy or chemo prevention treatment. The Regional Breast History Group are continuing to explore further avenues for promotion of the regional resource such as primary care and other public websites. Breast surgeons/breast oncologists have access to genetic testing for patients who have a cancer diagnosis, at that stage risk reduction with hormone tablets is not appropriate. Their genetic status may have an impact on their surgery and, more importantly, on their chemotherapy. These patients then have their cancer treated as necessary. Clinicians providing breast services are aware of the eligibility criteria for genetic testing, both in the context of patients diagnosed with breast cancer and patients who have attended breast clinics for assessment in whom there is no evidence of malignancy. Family history is routinely reviewed as part of breast assessment. Patients may be given advice, a review may be arranged for further follow up at the family history clinic, or a referral may be made to the Regional Genetics Service in the Belfast Trust as appropriate. The family members of these cancer patients will be followed up by the Genetics Service and may be referred to BRCA Clinic, or other family history service, depending on assessment of genetic status and risk due to their family history. They are likely to be offered the full range of interventions from risk reduction surgery to chemoprevention tailored to their individual risk, stage of life and general health status. Family history clinics are embedded within the breast service of each trust. A patient may also be referred by their GP to a family history clinic for assessment due to family history of breast cancer. Part of the family history clinic assessment is identifying women who may be eligible for genetic testing or may benefit from a further assessment with the cancer genetics service. Chemo prevention drugs are discussed with all patients at family history clinics as per National Institute for Health & Care Excellence (NICE) guidance.
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