Developing the infrastructure, processes and capabilities required for routine gene testing for cancer patients is a core component of the Mainstreaming Cancer Genetics (MCG) programme.
We have now fully implemented a ‘mainstream’ BRCA gene testing pathway for ovarian cancer patients at the Royal Marsden Hospital. This pathway allows patients to access BRCA testing through their routine oncology appointments. As well as being more flexible and patient-centred, this ‘mainstream’ gene testing pathway is faster and cheaper than traditional pathways, which require all patients to be referred to genetics to access testing.
200 Royal Marsden ovarian cancer patients have now received BRCA gene tests through the mainstream pathway.
Every woman with ovarian cancer offered a BRCA test chose to have testing.
A survey of women who received BRCA tests through the mainstream pathway showed that:
- 100% (77/77) were happy they had the test
- 99% (76/77) were happy to have the test through oncology
17% of women with ovarian cancer tested were found to have a BRCA mutation.
The genetic test results help the cancer team in deciding the best clinical management for the patient. They also provide information about the risk of future cancer, which is higher in the women with a BRCA mutation. All patients with mutations automatically have an appointment with genetics, so that the implications for themselves and their families can be discussed. Those without mutations can also have appointments with genetics should they wish to.
The mainstream BRCA gene testing pathway has now been adopted as standard practice by the Royal Marsden; all women with non-mucinous ovarian cancer are now routinely offered BRCA testing as a standard part of their care.
The MCG programme has made the full pathway and the training materials available through this site, so that other units can make use of them. We are now investigating how to further increase access to gene testing for other genes and other cancers.