Welcome to the Genetics/Hereditary Breast Cancer Clinic. We provide comprehensive genetic counselling services for individuals with a personal and/or family history of breast and/or ovarian cancers. Through a team approach, we provide integral genetic services while advancing patient care and research.
We are available to talk with you about whether the cancer in your family may be hereditary and if genetic testing is appropriate in the family. Where warranted genetic testing will be arranged and results and implications discussed. We can speak with you about different options on how to best manage and reduce your risk of developing certain types of cancers. We can also let you know if you are eligible for additional breast cancer screening through either the WCH High Risk Breast Screening clinic or the Ontario Breast Screening Program (OBSP). Necessary referrals can be made (where appropriate).
Research & Trials: we also work closely with the Familial Breast Cancer Research Unit and may be able to discuss research opportunities with you.
Why refer to our clinic?
- Get more information about what your personal or family history of breast and/or ovarian cancer may mean.
- Learn more about your lifetime risk to develop breast cancer.
- Find out if you are eligible for genetic testing (in this case, testing can be arranged).
- Find out how you can best manage or reduce your risks for developing breast and/or ovarian cancer
- Find out if you are eligible for any additional high-risk breast cancer screening
- If one of your relatives has had genetic testing and was found to carry a genetic mutation.
Eligibility for Genetic Counselling
Based on Ontario Ministry of Health and Long Term Care guidelines, individuals with a personal or family history of cancer as described below may be eligible for genetic counselling:
- Multiple cases of breast cancer (particularly when diagnosed before age 50) and/or ovarian* cancer (any age) in the family – especially in closely related relatives in more than one generation.
- Age at diagnosis of breast cancer less than 35 years.
- A family member diagnosed with both breast and ovarian* cancer.
- Breast and/or ovarian* cancer in Jewish families.
- Family member(s) with primary cancer occurring if both breasts, especially if one or both cancers were diagnosed before age 50.
- A family member diagnosed with invasive serous ovarian* cancer.
- Presence of male breast cancer in the family.
- Family member with an identified BRCA1 or BRCA2 mutation, or other breast cancer gene mutation (e.g. TP53, PTEN, CHEK2, PALB2, ATM etc.).
What To Expect
At the Genetics/Hereditary Breast Cancer Clinic, you will meet with a Genetic Counsellor. Genetic Counsellors, as part of a medical team, will review your medical and family history. They will support and help you and your family figure out how to best manage the cancer risk in the family.
Three main services are offered by Genetic Counsellors at the time of your visit. Please note that not every individual qualifies for all three services:
- Genetic counselling: Genetic counselling provides an individual or family with information and support regarding health concerns, which run in their family.
- Hereditary cancer risk assessment
- Genetic testing: Genetic Testing typically involves checking one or more of the genes you were born with to see whether they have a mutation (or problem) in them. Genes are units of inheritance, or the instructions to make the different parts of our body. Currently, it is estimated that it takes about 20,000 genes to make a person. Problems (or mutations) in genes can cause them not to work properly, which may lead to health issues (like an increased risk to develop cancer). Typically, we get some genetic material from a blood sample, but in some cases, a saliva samples may be used.
In order to be seen in the Genetics/Hereditary Breast Cancer Clinic and do assessments, we need some information about your personal and family history. We also may need additional information about the types of cancers in family members. Once referred, you will receive questionnaires to complete. We cannot book an appointment until we receive these completed documents. Once received, our clinic will contact you directly to schedule an appointment (either in person or by telephone).
The following individuals make up the genetics/hereditary breast cancer clinic team:
Clinic Director: Dr. Steven Narod, MD, FRCP
Research Laboratory Director: Dr. Mohammad Akbari MD, PhD
Genetic Counsellor: Nicole Gojska, MSc, MSc, CGC, CCGC
Genetic Counsellors can assess personal and family medical history to determine if an individual may have an increased risk for developing certain types of cancers. A Genetic Counsellor will discuss whether the cancer in a family may be hereditary, and if genetic testing is appropriate. Where warranted, genetic testing will be arranged and results and implications discussed. Genetic Counsellors can also provide information and support to an individual and their family, regarding the different options on how to best manage and reduce the risk of developing certain types of cancers.
Administrative Assistant to Dr. Narod: Ellen MacDougall
The Medical Secretary provides clerical support including telecommunications and customer service functions. The Medical Secretary facilitates efficient and timely access to specialty services by receiving and processing referrals and scheduling and confirming of appointments.
Genetics and Hereditary Breast Cancer Clinic
Women’s College Hospital
76 Grenville Street
Toronto, ON M5S 1B2
Hours of Service
Monday – Friday
6 a.m. to 7 p.m.
How can I make an appointment with the Genetics/Hereditary Breast Cancer Clinic?
A referral form (.pdf) or the Integrated Hereditary Breast & Preventive Ovarian Cancer Program needs to be completed. To be seen in the Genetics/Hereditary Breast Cancer Clinic, tick off the “Genetics” box in the Clinic Type section at the top of the form and complete reason for referral and include relevant documents. Typically this form is completed by a family physician, surgeon or oncologist. However, we do accept self-referrals (if warranted) to the Genetics/Hereditary Breast Cancer Clinic. In this case, the referring provider information is left blank.