For Drs

1Referral Information

We are happy to see all patients concerned about their familial cancer risk. This includes patients that have not had cancer themselves.

Genetic testing may affect a patient's treatment choices. Please refer patients with an active cancer early as testing may take 5 weeks and may have an impact on their surgery or chemotherapy options.

Address your referral to Dr Hilda High, Sydney Cancer Genetics. Please include:

  • your patient’s cancer history (including age at diagnosis and pathology report if available)
  • Reason for the referral +/- family history if known
  • patient’s preferred phone number

We see patients throughout Australian but have just one point of contact:

  • Fax: (61 2) 9304 0468. This is our preferred method for receiving referrals
  • Email: [email protected]
  • Post: PO Box 845 Broadway, NSW, 2007, Australia
  • To discuss the specifics of your patient’s case or to ask a general question Phone: (61 2) 9304 0438

We are a private practice and do not bulk bill.

We are happy to see patients via video Telehealth, anywhere in Australia.

The same Medicare rebates are available, whether the patient chose to be seen in person or via video Telehealth

We strongly support of rural patients. Unfortunately, the MBS Telehealth item 112 was abandoned from January 1st 2022. As a result we can no longer bulk bill these patients.

We always bulk bill genetic testing if the patient meets the Medicare criteria.

2Who should be referred?

How to recognise a high risk family history?

Inherited cancer syndromes are not common but being a mutation carrier can significantly increase cancer risk. Much of this risk can be reduced through screening and/or risk reducing surgery. Also, your patient may be at risk of other cancers and their family may also be at risk.

The following family histories are NOT likely to be related to an inherited cancer syndrome:

  • 3 relatives with ER+ breast cancer in the 60s or older
  • A mix of bladder, lung and throat cancer in the 50s or older
  • Melanoma and other skin cancers in the 50s or older

Cancer is common, particularly over the age of 55. The cancers in the families described above are likely to be due to longevity in a large family and/or environmental or lifestyle factors such as smoking or sun exposure. In general, individuals in these families should follow population-based screening and healthy lifestyle advice.

To aid with referrals, patients can complete a Family History Questionnaire to discuss with you.

For a detailed list by cancer type Read More

3Some Cancers that ALWAYS warrant a referral

Rare cancers and tumours (or rare kinds of common cancers) are much more likely to be associated with a hereditary cancer syndrome, especially if diagnosed before age 45. In some cases, the pretest likelihood may be 25% or even 50%!

This would include pheochromocytoma, paraganglioma, medullary thyroid cancer, young-onset triple negative breast cancer and diffuse gastric cancer to name a few.

Read More
4Using Medicare items 73295 and 73296 in breast cancer

Eligibility for Medicare funded testing using item 73295 and item 73296. Who is eligible and when should you test?

The executive summary is:

  • use item 73296 at diagnosis if the patient meets the 10% likelihood criteria (includes all triple negative breast cancer, breast cancer < age 40, male breast cancer or if there is Ashkenazi heritage)
  • use item 73295 after surgery in ER positive HER2 negative patients who have 4 or more positive lymph nodes who will be having adjuvant chemotherapy and who would be considered suitable for Olaparib if BRCA positive
  • use item 73295 in ER positive HER2 negative patients post neoadjuvant chemotherapy and after surgery if there is residual disease and considered suitable for Olaparib if BRCA positive
  • use item 73295 in ER positive HER2 negative patients during neoadjuvant chemotherapy and before surgery after discussion and agreement at an MDT that the patient has high risk disease (at least grade 3 or 1 node or >2cm) AND would be suitable for Olaparib AND is likely to have residual disease post chemotherapy AND it is unlikely that a result would be available in a timely manner (12 weeks) if testing were to be delayed until post surgery.
  • Do NOT use item 73295 if the patient is not suitable for either chemotherapy or Olaparib.

Read More