Many women say the most difficult part after learning about their risk is choosing the Health Care Professionals to help them manage their increased cancer risks. It is usual to have several Health Care Professionals involved in your care. This is because some will help manage your breast cancer risk and others any increased ovarian cancer risk (if applicable).
Below is a summary of what types of Health Care Professionals would usually manage the different types of cancer risk management options.
Breast Cancer Screening
A Breast Surgeon or a GP (local doctor) can arrange a mammogram for women at high risk. A GP can refer onto a Surgeon if a mammogram is abnormal or if they need an opinion about any screening outcomes.
Specialists are the only doctors who can order a Medicare rebated Breast MRI for women at high risk of breast cancer.
Risk Reducing Medication
GP’s, Breast Surgeons and Oncologists can all discuss and prescribe risk reducing medication for women at high risk of breast cancer.
Risk Reducing Surgery
Risk reducing bilateral mastectomy
This type of surgery is usually performed by two surgeons. A breast surgeon is responsible for removing the breast tissue and a plastic surgeon is responsible for reconstructing the new breasts. These surgeons usually work in teams, so when you choose a breast surgeon, that surgeon will refer you to the plastic surgeon they work with. There are some breast surgeons who are trained to perform both parts of the surgery, e.g. both remove and reconstruct breast tissue, these surgeons are often called breast oncoplastic surgeons.
Risk reducing bilateral salpingo oophorectomy
This type of surgery to remove the ovaries and fallopian tubes is recommended to be performed by a specialist gynaecologist known as a gynaecological oncologist. Having surgery under the care of a gynaecological oncologist is usually recommended as these operations can be described and discussed in much more detail as many factors will influence the exact type and timing of the surgery. These surgeons often usually work in large institutions where the pathology laboratories know how to closely examine the tissue for signs of small ovarian cancer.
Accessing doctors and risk management options
There are a variety of ways to access the right Health Care Professionals and care you need. Some women elect to be involved in a specialist clinic for women at high risk of breast and/or ovarian cancer. These clinics involve a team of Health Care Professionals that you can see all in one location/ clinic visit. Other women elect to be seen and cared for by several independent doctors.
Finding a specialist/clinic
Your Familial Cancer Clinic, will usually be able to advise you on what types of specialists/doctors you may need to see to help you manage your risk. In some cases they may be able to provide you with a list of local specialists or clinics that have an interest in caring for high risk women.
Your GP can provide you with a referral/s to any specialist doctors or clinics. They may know of specialists in your local area that they are able to recommend.
Asking family, friends and friends of friends for recommendations can also be useful.
When to get a second opinion?
Some women find it helpful to see a couple of surgeons before they make a final decision. This is because Health Care Professionals have different ways to explain the same information. It can also help women feel confident in the decision they make. Women can request to see another surgeon in the same practice or public hospital.