Family History Service Lynette Bracegirdle Clinical Nurse Specialist in Breast Care 12 th October 2016 By Gill Ogden People Centred Positive Compassion Excellence
What do we offer? • High quality Family History service • Dedicated administration time • Direct links with Regional Genetic Centre • Weekly clinics at Blackpool Teaching Hospitals which also covers North Lancashire and South Cumbria • Appropriately qualified Breast Care Nurses who deliver the service supported by Regional Geneticists • Family history database People Centred Positive Compassion Excellence
Family History Appointments April 2015 - April 2016 30 25 20 Attended DNA Hospital Cancellation 15 Hospital Rearranged Patient Cancelled Patient Rearranged 10 5 0 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 People Centred Positive Compassion Excellence
How is Breast Cancer risk described? • Nice guidelines refer to 3 levels of risk • Low – risk is same as general population 11% lifetime risk of developing breast cancer: 1 in 7 to 1 in 9 • Moderate – lifetime risk greater than 17% and less than 30%:1 in 4 to 1 in 6 • High 30% greater chance of developing breast cancer: 1 in 3 or above People Centred Positive Compassion Excellence
Clinic Assessment • Full risk assessment completed on the day • Patient informed of their exact risk • Advised on exercise, alcohol intake and weight how it can impact on risk • Hormonal factors discussed including contraceptive pill and HRT People Centred Positive Compassion Excellence
What happens next? • Moderate risk ladies are offered annual mammograms from age 40yrs to 49yrs • All mammograms are performed at Lancaster Breast Centre through NHSBSP • Blackpool Teaching Hospitals do not perform family history mammograms. • We co-ordinate the mammograms and recalls and request the mammograms each year • We see for results as needed. People Centred Positive Compassion Excellence
High Risk? • All patients assessed at high risk are referred either to St Marys or Nightingale Centre. • Referral for St Marys is to discuss genetic testing or risk reducing surgery if eligible • Referral for Nightingale Centre are to co- ordinate individualised high risk screening • All high risk screening is completed by either Manchester or Lancaster dependant on exact risk People Centred Positive Compassion Excellence
The Way Forward • Following audits of the Family History Service we now directly refer to Nightingale Centre for high risk screening without a Geneticist Consultation. This saves the patient an unnecessary appointment and is a significant financial saving for both the patient and the trust. • Streamlining the clinics has enabled us to use the clinic time more effectively reducing the DNA rate. People Centred Positive Compassion Excellence
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