Familial Cancer Testing – GP Pathway
Patients with a strong family history of breast and/or ovarian cancer are often seeking knowledge to determine whether they carry genes that will increase their future risk of cancer.
This awareness of inherited cancer susceptibility can alter their medical management, enabling increased screening and prophylactic risk-reducing surgery.
Access to hereditary breast and ovarian cancer genetic testing has previously been limited to referrals through state-funded genetics services and private medical specialists due to the complex nature of testing and associated genetic counselling requirements.
Genomic Diagnostics now facilitates GP referrals for this testing by offering a combined testing and genetic counselling package. Following a GP request for hereditary breast and ovarian cancer genetic testing, we will connect the patient with our qualified genetic counsellors partners, who will provide a pre-test and a post-test counselling sessions, with genetic testing occurring after the first session.
Family History and the Medicare Criteria
Many patients will have a family history of breast cancer, and a smaller number will also have multiple other cancers which have occurred in their family, for example, ovarian, colorectal and prostate cancers.
Only a small percentage of these will be due to inherited gene changes, and the percentage of these cases varies per cancer. Approximately 5 – 10% of breast cancers are due to inherited genetic variants while 20% of ovarian cancers are also thought to be hereditary.
Whilst a strong family history of one of these cancers is suggestive of an inherited predisposition, only patients with a personal history of cancer and a high chance of having a gene variant (based on clinical features and tumour characteristics) are eligible for Medicare funded testing (MBS Item #73296) when requested by a specialist.
Some families will have already undergone genetic testing and a specific familial variant may have been detected. Medicare will cover testing of family members for this singe gene variant when testing is requested by a specialist (MBS Item #73297). Refer to below for further details on how this can be organised.
Hereditary Breast & Ovarian Cancer Tests
$879
BraOVO Gene Panel + Genetic Counselling Package
- Pre-test genetic counselling session
- Genetic testing of 13 high and medium high risk genes – ATM, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, PALB2, PTEN, RAD51C, RAD51D, STK11, TP53
- Post-test genetic counselling session
Time to results, including counselling: 7 – 9 weeks
Frequently Asked Questions
Hereditary Breast and Ovarian cancer gene testing is complex and we have answered your patient’s most frequent queries below. They may help you explain the testing and the process to get tested further. Do not hesitate to reach out to us on 1800 822 999 with any queries.
Some families may have an increased risk of developing certain types of cancer through the inheritance of harmful changes (pathogenic variants) in certain genes.
Testing for these genetic variants can determine whether a patient might be at increased risk of developing cancer and suggest an appropriate prevention or surveillance strategy.
The genes analysed in this panel, ATM, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, PALB2, PTEN, RAD51C, RAD51D, STK11, TP53, are all high and medium high risk genes for breast and/or ovarian cancer.
Genetic testing for inherited cancer is a complex process that generates results that can have significant medical and psychological implications for patients and their families. As part of our laboratory accreditation, Genomic Diagnostics must ensure that patients receive appropriate genetic counselling for this type of testing.
Genetic counsellors are specifically trained to provide pre-test counselling to discuss the test, the test outcomes and the potential implications of the results, and following the release of results, provide post-test counselling to discuss those results and what further action, if any, might be required.
The Medicare schedule currently contains three item numbers relevant to hereditary breast and ovarian cancer genetic testing.
These are only rebatable if requested through a specialist and if the patient meets the criteria set out in them.
In summary:
MBS #73295 – for patients with ovarian/fallopian/peritoneal cancer for access to the drug olaparib.
MBS # 73296 – for patients with a personal history of cancer AND have a >10% chance of having a familial variant based on a quantitatie risk algorithm.
MBS #73297 – predictive familial cancer test for a single gene variant where a family member has been identified as having this variant.
If your patient has a family member with a known familial variant, such as BRCA1, it is possible to get them tested for just that variant.
They must be able to provide a report from the family member, stating the exact details of the variant so that the laboratory can test for it.
Your patient will still need to undertake genetic counselling and pay for the package up front, however a partial rebate will apply.
Genetic testing for inherited cancer is most often accessed through state-funded Familial Cancer Services at major public hospitals, and private medical specialists and clinics with an interest in inherited cancers. These options continue to be available.
Unfortunately, due to increased awareness of testing, wait times for pre-test counselling and genetic testing can be very long (6 -12 months) and can be even longer for patients in regional and remote areas.
While testing through public and private services can be free of charge this is not always the case, as patients may not meet the eligibility requirements of the medical service or Medicare criteria.
The Genomic Diagnostic option for breast and ovarian cancer genetic testing requested by GPs provides medically referred, rapid and safe access for patients looking for an alternative offering to traditional pathways to testing. We recommend that you discuss with your patient which is the right option for them.
Resources
Leading the way to improved health
results in the shortest turnaround time.
