Cancer genetics is the study of how inherited changes in genes can cause an increased risk of cancer.
This service undertakes risk assessment for individuals who are either affected with cancer themselves and/or have a family history of cancer. These assessments include how likely it is that the cancer is genetic, what an individual’s risk is, whether genetic testing is possible or appropriate, and how best to deal with the increased risk. This may include information about genetic testing, referral for screening or consideration of risk reducing surgery.
We offer services to individuals and families at risk of common cancers (eg breast and bowel cancer) and to those with inherited cancer syndromes such as FAP, MEN, VHL and Gorlin.
Our clinics are held on the 6th floor of Saint Mary’s Hospital or in other hospitals on the Manchester University NHS Foundation Trust main site. We also offer out-reach clinics that are held in cancer centres in the North West, The Christie Hospital in Manchester and the Rosemere Cancer Centre at Royal Preston Hospital. We are happy to see patients who live outside the North West of England who wish to be seen at our centre if referred by their GP or specialist. We also offer urgent appointments. These are usually available only at St Mary’s Hospital but occasionally at out-reach clinics if there is space available. We offer ward consults for in-patients at Manchester University NHS Foundation Trust.
Any patient with a family history of a known mutation should be referred directly to the regional genetic service with the name of the person in whom the mutation has been identified and where the testing was done.
For an individual with a personal history of cancer, please enclose a copy of the histology report.
Personal or family history of cancer
Assessment of cancer risk is based on the analysis of a three generation family tree on both sides of the family.
- A first degree relative is a parent, sibling or child.
- A second degree is an aunt/uncle, grandparent or grandchild.
- Affected relatives must be on the same side of the family (ie maternal or paternal).
- A lesser history of cancer may significantly increase the risk if the family is of Jewish or non White European origin. If in doubt, please contact us.
When making a referral, it is useful to complete the Family history of cancer form.
Breast Cancer Referral Requirements
All unaffected women with a family history of breast cancer only should be referred to the local family history clinic in the first instance unless there is a known mutation in the family.
- One first degree relative with breast cancer <30 with any other history of cancer < 60 in another first degree or second degree relative.
- Two relatives (first or second degree) diagnosed with breast cancer at an average age of < 50.
- Three relatives (first or second degree) diagnosed with breast cancer at an average age of < 60.
- Four relatives diagnosed with breast cancer at any age.
- One first or second degree relative with breast cancer < 50 and one first or second degree relative with ovarian cancer.
- Two relatives (first or second degree) diagnosed with breast cancer at an average age of < 60 and one first or second degree relative with ovarian cancer at any age.
- One first degree male relative with breast cancer < 60.
- One first degree male relative with breast cancer at any age and one first or second degree relative with breast or ovarian cancer.
- A woman diagnosed with a grade 3 triple negative breast cancer < 40 with/without a family history. Please send histology report(s) with referral.
If the patient has had cancer, they can be included in the total number of family members affected.
One relative with bilateral primary breast cancer is equivalent to two affected relatives.
A paternal family history is as important as maternal family history.
See also the 2013 NICE guidelines for familial breast cancer.
All affected relatives must be on the same side of the family.
- Two or more first or second degree relatives diagnosed with ovarian cancer at any age.
- One first or second degree relative with ovarian cancer and one first or second degree relative with breast cancer, at least one of whom was diagnosed < 50.
- One first or second degree relative with ovarian cancer and two first or second degree relatives with bowel and endometrial cancer (on the same side of the family), at least one diagnosed < 50.
- One first degree relative with breast and ovarian cancer as primaries, at least one diagnosed < 60.
- A woman diagnosed with a high grade serous ovarian cancer < 60 with/without a family history. Please send histology report(s) with referral.
If the patient has had cancer, they can be included in the total number of family members affected.
A paternal family history is as important as maternal family history.
All affected relatives must be on the same side of the family.
- One first degree relative diagnosed < 35.
- Two first degree relatives with average age at diagnosis < 60.
- Three or more first or second degree relatives diagnosed at any age.
- Bowel and endometrial cancer in first or second degree relatives with bowel cancer diagnosed < 50.
- Bowel and ovarian cancer in first or second degree relatives with bowel cancer diagnosed < 50.
- An individual diagnosed with bowel cancer themselves < 40 with or without a family history. Please send histology report(s) with the referral.
- Two endometrial cancers < 60 even if no bowel cancer.
- Patients with a personal and/or family history (suggestive) of FAP, Lynch Syndrome, Juvenile Polyposis Syndrome and Peutz-Jegher Syndrome.
If the patient has had cancer, they can be included in the total number of family members affected.
All affected relatives must be on the same side of the family
- A man with prostate cancer < 60 with one or more first degree or second degree relatives with prostate cancer < 60.
- Two first or second degree relatives with prostate cancer both < 60.
- Three relatives on the same side of the family with prostate cancer any age.
- A man with prostate cancer < 60 and a family history of breast or ovarian cancer – please discuss before referral.
