Breast cancer is the most common invasive cancer diagnosed in women in Ireland. The lifetime risk of developing breast cancer is 10% to 11% for the general population. Five to ten per cent of all breast cancers are explained by the presence of BRCA 1 or BRCA 2 gene mutations, which increases the lifetime risk to 60% to 80%.
The HSE’s National Cancer Control Programme (NCCP) established a National Hereditary Cancer Programme in 2011 with the National Centre for Medical Genetics in Crumlin Hospital. There are two groups of women involved – those who have been diagnosed with cancer and those who have a family member who has been found to carry a gene mutation.
The NCCP has launched cancer genetic clinics in St James's and the Mater Hospitals in 2011 and 2012 respectively, with the addition of a new service in Cork University Hospital in 2013. The programme is primarily focussed on patients who have hereditary breast, ovarian and bowel cancer.
This has led to a 30% increase in the number of patients seen and assessed. In 2012 the clinics in St James’s and the Mater Hospitals have assessed and tested almost 200 women (with breast or ovarian cancer) for the BRCA gene mutation. This represents over a 100% increase in the number of women tested nationally, compared with 2011.
The NCCP has confirmed that there are waiting times for genetic testing for patients with suspected hereditary cancer mutations. This delay relates mainly to the need for genetic counselling prior to being tested, in order that women are fully informed of the implications of a positive test result. It is inappropriate to have the test without counselling.
The NCCP and the National Centre for Medical Genetics are continuing to work to ensure that the service is expanded to meet national needs. This improvement in access to counselling and genetic testing will reduce the current waiting times.
The NCCP will also work to implement the recommendations of the recent HIQA Report on Breast Cancer Surveillance, which outlined the potential benefits of a standardised surveillance programme for women aged less than 50 years at elevated risk of breast cancer due to a genetic predisposition or a strong family history.