Mainstreamed Hereditary Cancer Testing

OVERVIEW

Healthcare providers outside of the BC Cancer Hereditary Cancer Program (HCP) can order multi-gene panel testing through CGL for patients who meet specific criteria.  This is known as “mainstreamed” hereditary cancer testing.

INDICATIONS

  • Breast Cancer
    • HER2-negative breast cancer, eligible for Olaparib
  • Hereditary Breast and Ovarian Cancer
    • Breast cancer ? age 35
    • Two primary breast cancers, with at least one ? age 50
    • Triple negative (ER-PR-HER2-) breast cancer ? age 60
    • Breast cancer ? age 50 AND no family history known due to adoption
    • Ovarian, fallopian tube or peritoneal cancer (non-mucinous epithelial; incl. STIC)
    • Male breast cancer
  • Pancreatic Cancer
    • Pancreatic ductal adenocarcinoma
    • Pancreatic neuroendocrine tumour
  • Prostate Cancer
    • Metastatic prostate cancer
  • Medullary Thyroid Cancer
  • Paraganglioma (includes pheochromocytoma)
  • Renal Cancer
    • Age ? age 47
  • Ashkenazi Jewish Heritage
    • Ashkenazi Jewish ancestry and a personal or family history of breast, ovarian, pancreatic, or high-grade prostate cancer
  • Other
    • Confirmation of a pathogenic variant result (include relevant report(s) from tumour testing or clinical trial/research testing)
    • Approved by Hereditary Cancer Program

Please note: the indications for the Hereditary Cancer Panel will likely change over time. Please review the requisition for the most up-to-date list of eligibility criteria.

For all other patients, please initiate a referral to the Hereditary Cancer Program.

TEST ORDERING

If your patient is eligible for mainstreamed testing, you can use the Hereditary Cancer Panel requisition to order genetic testing for your patient. Details about the assay can be found on the Hereditary Cancer Panel page.

You can order this testing in CERNER using test code “Hereditary Cancer Genetics Panel”. You will still need to give a copy of the requisition to your patient.

If you choose to offer mainstreamed testing to your patient, you will be responsible for:

  • Discussing the testing with your patient and confirming that they consent to proceed.
  • Completing the requisition and providing it to your patient.
  • Following up with your patient if they do not have their blood drawn.
  • Disclosing the genetic test result to your patient.

See our PDF checklist summarizing these steps.

NOTE: Patient samples may be sent to a laboratory in the USA for testing. Personal information (name, date of birth, sex, cancer history) would be sent with the sample. Please contact geneticcounsellor @ bccancer.bc.ca if you have any questions or concerns.

The HCP team will support you by:

  • Reviewing all requisitions for mainstreamed genetic testing to ensure that they are complete and that the patient is eligible for testing.
  • Reviewing all mainstreamed genetic testing reports.
  • Creating reflex referrals to HCP for all patients who have a pathogenic variant, likely pathogenic variant, or a concerning variant of uncertain significance (VUS)
  • Notifying you by email when a pathogenic/likely pathogenic or concerning VUS is identified and a reflex referral to the HCP has been made for your patient.

PATIENT INFO SHEETS

  1. Pre-Test Information Sheet
  2. Positive Result Information Sheet
  3. Negative Result (includes VUS) Information Sheet

FURTHER INFORMATION

For more information on HCP’s mainstreamed genetic testing pathway, including orientation slides and additional patient information materials, please visit the HCP website.