Proposed service for those at high risk of breast and ovarian cancer

Plans are afoot to set up a nationwide service for New Zealand women who are at high risk of breast and ovarian cancer.

The proposal has been put forward by Dunedin consultant, Dr Simone Petrich, who works as a breast surgeon and obstetrician and gynaecologist.

“In these roles I see women from a breast as well from as from a gynaecological perspective and I’ve noticed shortcomings in the current structure which I hope will be overcome with the introduction of a service for women at high risk of these types of cancers," she says.

Dr Petrich, says the aim is to establish a structured system to not only identify those families at high risk, but to ensure they receive the follow-up care they need based on clear national guidelines.

The plan is to integrate with the already existing Service for Familial GastroIntestinal (GI) Cancer which serves those at risk of hereditary gastrointestinal cancer.

This service offers assessment of bowel cancer risk for people with a family history of GI cancer, facilitates the diagnosis of hereditary cancer by confirming the family history, offers surveillance recommendations and co-ordinates surveillance for high-risk families.  It also offers specialist management advice and provides information for families on familial GI cancer.

Dr Petrich says this is a good model.  “We would like to take that great model and apply it to women at greater risk of developing breast and ovarian cancer.  We could expand the database and improve patient care.”

Under her proposal those found to be at high risk of breast and ovarian cancer would have better coordination and oversight of the many aspects of their care, including access to information, genetic testing, counselling, and support if they wanted medical intervention, such as medication or risk-reducing surgery.

Dr Petrich says the register would ensure those at high risk are identified and followed-up for the rest of their lives and it would reduce the chance of women getting “lost in the system”.

Establishing a high risk registry would also help researchers to learn more about high risk patients and build-up a more comprehensive database.

“We don’t know a lot about what happens with high risk patients in New Zealand. For example, we don’t know how many have risk-reducing mastectomies,” Dr Petrich says.

The registry would also ensure that patient care is well co-ordinated and consistent nationwide and it would enable recommendations for high risk patient care to be developed.

The proposal is currently being submitted to the National Health Committee.

3 March 2016

Article Type: