ABSTRACT
After gender and increasing age, a positive family history is the greatest-known predictive risk. The role of genetics is also becoming an important part of breast cancer care as it can influence patient management, including surgery and chemotherapy. Patients either present their family history of breast and /or ovarian cancer to their general practitioner or it is raised by the clinician in the symptomatic clinic. This chapter is based on the experience of a ‘hub and spoke' model use in South East England, serving a population of 525,000 with approximately 250 family history referrals a year. Risk-reducing mastectomies for women without a personal history of breast cancer are appropriate for only a small proportion of women, who are from high-risk families and should be managed by the multidiscplinary team.
