Step 1 – See a Consultant Genetic Counsellor
Your first consultation will be with a Consultant Genetic Counsellor with experience and expertise in hereditary cancer predispositions. They will review your results with you in more detail, explaining your personal risk and your options to manage these risks such as enhanced screening, risk reducing surgery and others. They will give you personalised risk information and provide you with psychosocial support. We know this can be a challenging time for individuals and the aim is to give you all you need to make an informed and supported decision about your future care plan and sharing the relevant information with your relatives.
Depending on your decision and the clinically appropriate advice you will be referred on to see a Consultant Gynae-Oncologist or Consultant Breast Surgeon. You may also benefit from seeing other specialists within the multi-disciplinary team such as a clinical psychologist and this will be discussed with you if needed.
Step 2 - Screening
We will arrange for you to have some baseline tests, including imaging the ovaries and the breasts. This will provide a baseline for any future screening you may have with us and also check for any measurable abnormalities.
Ovarian assessment
We’ll arrange for you to have a gynaecological ultrasound scan and a CA-125 blood test. The scan will provide a picture of your ovaries and the blood test will look at a specific protein marker that can monitor for signs of ovarian cancer.
Breast screening
We’ll also arrange for you to have a breast MRI (timed to your menstrual cycle), so that we can capture detailed images and check for any changes to your breasts. Your consultant may also recommend having a mammogram depending on your age, but this isn’t always necessary.
Step 3 - Results
Your test results will usually be available within two working days, and we’ll arrange a consultation with an expert clinician to discuss your results.
Your consultant will be able to explain the results of your screening and create a personalised care plan tailored to your individual needs. They’ll discuss the options with you and make sure you have all the information you need to make an informed decision about your future care.
If you would benefit from seeing other specialists in the team, your consultant can make a direct referral to their colleagues who also specialise in looking after families with BRCA risks.
Common questions about BRCA
There are two types of BRCA gene, BRCA 1 and BRCA 2, they are part of the body’s natural defence against cancer. These genes are known as tumour suppressors and can help to keep breast, ovarian and other types of cells from developing and multiplying too rapidly or in an uncontrolled way.
Some people have a BRCA gene mutation which can prevent the genes from working properly. This increases a person’s risk of developing some types of cancer.
Being a BRCA carrier means that you have a gene change (mutation) that increases your risk of being diagnosed with some cancers. Although being a BRCA carrier increases your risk of developing cancer it does not mean that you will definitely get cancer during your lifetime.
There are steps you can take to manage your risk of developing cancer, increased screening can help to check for any early changes to cells or find cancer in its earliest stages. Some people choose to have risk reducing surgery, which may include a mastectomy or surgery to remove your ovaries and fallopian tubes for example. These decisions will be personal to you, we have a team of experts who can give you the information you need to consider these choices.
More generally, maintaining a healthy diet, managing your weight, giving up smoking and keeping to the recommended alcohol intake, can all help to reduce your overall risk of developing cancer.
If you are a BRCA carrier, then it’s possible that other members of your family may also have inherited this gene mutation. You can inherit a BRCA gene mutation from either your mother or your father. Adult members of your family may choose to have genetic testing to see if this they are a BRCA carrier too. Your parents, their siblings and nieces and nephews can be tested, your siblings can also be tested if they are over 18 years of age.
It's important to remember that being diagnosed as a BRCA carrier means you have an increased risk of developing some types of cancer, but it does not mean you will definitely have cancer in your lifetime.
Men can be a BRCA carrier, this can increase their risk of developing some cancers including prostate, pancreatic and breast cancer. Our specialist genetic testing service is available to both men and women who are worried that they may have inherited a BRCA gene mutation.
Our specialists
Our bespoke clinic provides a multi-disciplinary approach, from our genetic counsellors and consultant geneticists to expert consultants in breast and gynaecological cancers, the team work with you to ensure a personalised care plan is tailored to your individual needs.
Your consultant can also make direct referrals to other specialists in the wider team, this includes other consultant surgeons, oncology colleagues or specialists in emotional and psychological support.