Breast cancer

Question 1

What is the criteria for 2 WW for suspected breast cancer?

Answer 1

Aged 30 and over and have an unexplained breast lump with or without pain or Aged 50 and over with any of the following symptoms in one nipple only: - Discharge - Retraction - Other changes of concern

Question 2

In secondary care, what sort of carrier probability calculation method should be used for specialist referral to a specialist genetic clinic ?

Answer 2

BOADICEA or Manchester scoring system

Question 3

In a specialist genetic clinic, what carrier probability calculation method can be used to assess the probability of a BRCA1 or BRCA2 mutation

Answer 3

BOADICEA or Manchester scoring system

Question 4

Under what criteria should referral to secondary care be offered, who don’t have a personal history of breast cancer?

Answer 4

one first-degree female relative diagnosed with breast cancer at younger than age 40 years OR

one first-degree male relative diagnosed with breast cancer at any age OR

one first-degree relative with bilateral breast cancer where the first primary was diagnosed at younger than age 50 years OR

two first-degree relatives, or one first-degree and one second-degree relative, diagnosed with breast cancer at any age OR

one first-degree or second-degree relative diagnosed with breast cancer at any age and one first-degree OR

second-degree relative diagnosed with ovarian cancer at any age (one of these should be a first-degree relative) OR

t_hree first-degree or second-degree relatives diagnosed with breast cancer at any age_.

Question 5

Under what criteria should referral to specialist genetic clinic be offered, who don’t have a personal history of breast cancer?

Answer 5

At least the following female breast cancers only in the family:

two first-degree or second-degree relatives diagnosed with breast cancer at younger than an average age of 50 years (at least one must be a first-degree relative) or

three first-degree or second-degree relatives diagnosed with breast cancer at younger than an average age of 60 years (at least one must be a first-degree relative) or

four relatives diagnosed with breast cancer at any age (at least one must be a first-degree relative).

or

Families containing one relative with ovarian cancer at any age and, on the same side of the family:

one first-degree relative (including the relative with ovarian cancer) or second-degree relative diagnosed with breast cancer at younger than age 50 years or

two first-degree or second-degree relatives diagnosed with breast cancer at younger than an average age of 60 years or

another ovarian cancer at any age or

Families affected by bilateral cancer (each breast cancer has the same count value as one relative):

one first-degree relative with cancer diagnosed in both breasts at younger than an average age 50 years or

one first-degree or second-degree relative diagnosed with bilateral cancer and one first or second degree relative diagnosed with breast cancer at younger than an average age of 60 years. or

Families containing male breast cancer at any age and, on the same side of the family, at least:

one first-degree or second-degree relative diagnosed with breast cancer at younger than age 50 years or

two first-degree or second-degree relatives diagnosed with breast cancer at younger than an average age of 60 years. or

Formal risk assessment suggests so:

10% chance of gene being harboured in the family