Table 1 Care pathways
Genetic status | Genetic service | No genetic services |
|---|---|---|
Low risk | Reassured that they are at population risk. Enter national screening programme at 50 years of age. | Enter national screening programme at 50 years of age. |
Moderate risk | Phone counselling and regular mammography for women who wish to have presymptomatic surveillance. Annual mammography from 40 to 50 and every 18 months from 50 to 60 years of age. Women enter the national screening programme at 60 years of age. | Enter national screening programme at 50 years of age. |
High risk – did not inherit a BRCA1/2 mutation | Face-to-face counselling and genetic testing having found a BRCA1/2 mutation in a cancer-affected relative. Informed that they are at population risk. Enter national screening programme at 50 years of age. | Enter national screening programme at 50 years of age. |
High risk – inherited a BRCA1/2 mutation | Face-to-face counselling and genetic testing having found a BRCA1/2 mutation in a cancer-affected relative. Women can then opt to have regular mammography, masteclomy, oophorectomy and regular mammography or mastectomy with oophorectomy. Surveillance is provided in the form of annual mammography from the age of 35–50 years and every 18 months from 50 to 60 years of age. Women enter the national screening programme at 60 years of age. | Enter national screening programme at 50 years of age. |
High risk – unknown mutation in family | Face-to-face counselling but no genetic testing as a BRCA1/2 mutation was not found in a cancer-affected relative. Women can then opt to have regular mammography, mastectomy, oophorectomy and regular mammography or mastectomy with oophorectomy. Surveillance is provided in the form of annual mammography from the age of 35–50 years and every 18 months from 50 to 60 years of age. Women enter the national screening programme at 60 years of age. | Enter national screening programme at 50 years of age. |
