The integrated, multidisciplinary clinic: a new model for the ongoing management of women at high genetic risk for breast and ovarian cancer

摘要

An important minority of Australian women have a strong hereditary predisposition for the development of breast and/or ovarian cancer. Evidence-based cancer risk reduction strategies for this group are complex and need to be tailored to individuals and refined as new evidence emerges. In Australia, risk management services for these women are largely unidisciplinary. Here we describe the development, feasibility and cancer and screening outcomes for the first two years of an Australian multidisciplinary Risk Management Clinic (RMC). Data on screening test results and risk-reducing surgery were collected prospectively using standardised forms. Data on clinical and genetic characteristics were collected by medical record review. A total of 98.8 years of follow-up were available on the 92 clients. The average age of clients was 36 years and 20 (22%) carried a documented mutation in BRCA1 or BRCA2. One interval breast cancer had been diagnosed and screening investigations resulted in three investigational operative gynaecological procedures for non-malignant disease. Forty-three (47%) clients were participating in at least one research project. It is feasible in the Australian setting to run a multidisciplinary risk management clinic, with integrated clinical research programs, within the setting of a Family Cancer Centre.