Women’s College Hospital
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The Hereditary Breast and Ovarian Cancer (HBOC) Clinic supports women who have been identified with a pathogenic variant (also known as mutation) in cancer predisposition genes like BRCA1 and BRCA2. These gene mutations can make them more likely to develop breast and ovarian cancer. The clinic provides access to follow-up care and support to manage their increased risk, including access to enhanced cancer screening, cancer prevention and psychosocial services.
Figure 1 illustrates the different types of specialties that women may access through the HBOC Clinic to help manage their risk of cancer. The specialist they see depends on their gene mutation and the specific cancer risks linked to that gene. For example, if someone has a BRCA2 gene mutation, they may visit a dermatologist to address the higher risk of melanoma (a type of skin cancer).
Once a patient has been identified with a pathogenic variation (mutation) in a cancer predisposition gene, they may be referred by their healthcare provider to the HBOC clinic.
- The nurse practitioner will do an intake assessment with the patient to confirm their genetic mutation and go over the current healthcare needs of the patient.
- Our clinic follows the guidelines of the National Comprehensive Cancer Network (NCCN), which are specific to the type of gene mutation identified.
The HBOC Clinic keeps track of patients who have mutations in the following genes:
ATM, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, MSH2, MLH1, MSH6, PMS2, EPCAM, NF1, PALB2, PTEN, RAD51C, RAD51D, STK11, TP53.
All women who are referred to the clinic will receive appropriate referrals to the specialties they require based on the age of the patient, the personal preferences of the patient, and the gene specific management recommendations. Patients will connect with the HBOC clinic nurse practitioner on an annual basis, or as needed.
“The coordination of all the people was the best part.”
“The team is incredibly knowledgeable and spent a lot of time with me.”
“Very trans-inclusive and respectful; received very thorough information.”
“This is a fantastic clinic, meeting the different care providers allowed me to get the big picture and have my questions answered.”
If you wish to access the Ontario Health Insurance Plan (OHIP) funded HBOC Clinic, you can contact your care provider (physician, nurse practitioner, genetic counselor) and request that they submit a referral to the Women’s College Hospital Breast Centre – HBOC Clinic.
Once your referral has been received and it has been determined that you are eligible for the HBOC Clinic, you will be sent an Intake Assessment Form. This is filled out prior to your first appointment.
Your Intake Assessment Form will be reviewed and a virtual appointment will be booked with the HBOC Clinic nurse practitioner. Following this, you will be scheduled for additional HBOC Clinic appointments with a variety of care providers/specialists based on your individual needs and goals. Some of these appointments may be in-person and some may be virtual. You may see one or several providers depending on your individual plan of care. These providers may include a: plastic surgeon, general surgeon, general practitioner in oncology, gynecologist, social worker, genetic counsellor, peer support worker and/or genetic counselor.
Frequently Asked Questions
Please click the following link to see options for genetic testing at Women’s College Hospital.
In most cases, you will see providers at Women’s College Hospital (either in-person or with virtual appointments). If you do not live within the Greater Toronto Area, there may be opportunities for virtual appointments for some specialties, or you may be able to access services in your own area (including breast screening).
This information can be found on the genetic testing documents that your genetics provider would have shared with you or your primary care provider. If you do not have access to these documents, please contact the clinic where you had your genetic testing done to obtain a copy of your genetic test results.
Currently, the clinic focuses on individuals who were born female. There is a clinic at Sunnybrook Health Sciences Centre that follows men.
No. Anyone in Ontario with a valid health card can access services at the HBOC clinic.
We want to make your follow-up management as convenient as possible. If you want to continue to have your screening done close to home, this can be accommodated. Some women may only wish to use this clinic to access one specialty, like breast surgery for risk-reducing mastectomy. When you talk to the nurse practitioner, he/she will go over your preferences and will develop a management plan specifically for you.
Any woman who has been identified with a mutation in a breast/ovarian cancer predisposition gene is eligible to access the clinic. Typically, genetic testing is done after the age of 18 years.
If you would like to refer your patient to the HBOC Clinic at Women’s College Hospital, please find the form below. Please indicate on the referral that you would like your patient seen in the “HBOC Clinic” for multidisciplinary cancer genetics management.
Resources are available for both patients and health care professionals. The following are websites and links that may provide answers to many of your questions. Please note, some of the links on these pages may go to external websites.
- BRCA Women’s College Cancer Genetics Newsletter
- What You Need To Know: Preventative Surgery to Remove your Fallopian Tubes and Ovaries
- Understanding Skin-sparing and Nipple-sparing Mastectomies
- FORCE – Facing Hereditary Cancer Empowered
- Canadian Cancer Society
Each year, the Peter Gilgan Center for Women’s Cancers hosts a virtual Hereditary Cancer Webinar series.
You can see the latest videos below, and previous years’ videos are archived on our youtube channel
2023 Virtual Hereditary Cancer Webinars