Breast cancer (A/P-AFF)
Individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified (Adult and Paediatric Conditions in AFFECTED Patients)
Emergency referrals
If any of the following are present or suspected, refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
- No referrals to emergency relating to genetic testing or review
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- Breast cancer with at least one of the following:
- distant (outside loco-regional areas) metastatic disease
- results of genetic testing (if offered) will influence local or systemic treatment considerations
- breast and ovarian cancer in the same patient
- age ≤ 30 years and/or a family history of Li Fraumeni associated cancer and planned for adjuvant radiation
Category 2
Appointment within 90 days is desirable
- Breast cancer with at least one of the following:
- a patient who has a limited life expectancy due to advanced age and/or co-morbidities
- inflammatory
- triple negative (TNBC)
Category 3
Appointment within 365 days is desirable
- Breast cancer that does not meet Category 1 or 2 criteria
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
Not an exhaustive list
- The offer of an appointment by GHQ does NOT guarantee that the patient will be offered a publicly funded gene test.
- Providing information about the timeframe for which genetic consultation and testing (if offered) is required, can assist in ensuring the referral is appropriately prioritised to inform treatment decisions.
- Referral for genetic assessment and counselling is recommended if:
- breast cancer diagnosed at age < 40 years
- triple negative breast cancer (TNBC) diagnosed at age ≤ 50 years (TNBC: oestrogen, progesterone and HER2 receptor negative)
- TNBC at any age AND a first or second degree relative with breast cancer
- lobular breast cancer AND a family history of lobular breast or diffuse-type gastric cancer
- personal history of two primary breast cancers where the first occurred ≤ 50 years
- male breast cancer at any age
- Jewish or Dutch ancestry
- breast cancer and a personal or family history suggestive of:
- Peutz-Jeghers syndrome
- Cowden syndrome (also refer to GHQ website for details regarding characteristic features)
- Li Fraumeni syndrome
- Neurofibromatosis type 1 (NF1)
- reported family history of ovarian cancer
- a Manchester Score of ≥ 15
- If the patient is an UNTESTED blood relative of a person with an identified mutation in a cancer predisposition gene please refer to the Untested blood relative condition within the Genetics CPC
- If the patient has undergone mainstreamed and/or private genetic testing refer to the Mainstreamed or private testing condition within the Genetics CPC
- Eligibility for publicly funded genetic testing will be determined using eviQ criteria (See criteria for BRCA1/2, TP53, CDH1, PTEN, STK11).
- Patients will be asked to provide detailed family information either during a telephone consultation (if urgent) or via a family history questionnaire (Cat 3). One or more Consent to Release information forms may be provided to forward to family members to obtain their consent to confirm details of the reported family history.
- GHQ will facilitate self-funded BRCA1 and BRCA1 gene testing for patients who do not qualify for publicly funded gene testing and wish to pursue this option after genetic counselling.
- If the patient fulfils eviQ criteria for genetic testing and has a very limited life expectancy, arrange for two separate blood collections of 2x4mL EDTA tubes each to be sent to the Molecular Genetics Laboratory, Pathology Queensland (RBWH) for “DNA extraction and storage” prior to or at the time of referral. Advise Pathology Queensland that these specimens have been collected in accordance with Genetics Health Queensland protocols.
Referral requirements
A referral may be rejected without the following information.
Send referral
Hotline: 1300 364 938
Fax: 1300 364 952
Electronic: eReferral system
Mail: Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
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