Preventing Cancer with Medications Telehealth (PCMed) Service - Information for health practitioners

Almost half of the 20,000 new breast cancers diagnosed in Australia each year occur in the 20% - 25% of women who are at moderate or high risk for the disease, based on their risk factors. Many of these cancers are preventable.

Multiple randomised controlled trials have shown that a daily tablet, taken for 3-5 years, reduces the relative risk of breast cancer by 30%-60%. The preventive benefit continues for many years even after the prevention medication is ceased. Australian guidelines confirm these breast cancer prevention medicines as a standard of care for women whose risk is > 1.5 times the population risk for a woman of the same age. A woman’s personal breast cancer risk can be assessed using iPrevent. Our research has shown that, despite the national guidelines, few eligible Australian women are offered these medications. Australian general practitioners often report they lack adequate knowledge and confidence to initiate prescribing these breast cancer prevention medications. The novel Preventing Cancer with Medications Telehealth Service responds to this evidence-implementation gap.

The Preventing Cancer with Medications Service commenced at Peter Mac in late 2023. It is co-led by Professor Kelly-Anne Phillips (medical oncologist) and Katrina West (nurse practitioner). The Service is delivered via Telehealth. It provides the initial nuanced discussions with women about the potential benefits and disadvantages of breast cancer prevention medications for them personally, to help them make an informed decision. Women are discharged back to their referring doctor once a decision has been made. For women who choose to try prevention medications, the Service ensures they are tolerating the medications before discharging them. Ongoing prescriptions are provided by the GP and the Preventing Cancer with Medications Service provides support to women and their referring doctors and GPs through a dedicated telephone hotline.

Eligibility Criteria

• Willing to consider breast cancer prevention medications
• Assigned female at birth.
• Aged 20 to 70 years.
• No personal history of invasive breast cancer or ductal carcinoma in situ (DCIS).
• One of the following:
  • residual lifetime breast cancer risk at least 20% (see iPrevent) or,
  • 10-year risk of at least 5% (see iPrevent) or,
  • history of LCIS or atypical hyperplasia or,
  • prior thoracic irradiation before the age of 35 (and the radiation was given at least 5 years ago).
• Does not require germline genetic testing to further clarify risk of breast cancer - those who meet criteria for formal consideration of  genetic testing for cancer predisposition should be referred to a Familial Cancer Centre. They can subsequently be referred to the PCMed Service as needed.

Referral Information

1. Access the link to view the referral guidelines: Preventing Cancer with Medications Service Referral Guidelines
2. Please send a referral letter addressed to ‘Professor Kelly Phillips, Preventing Cancer with Medications Service at the Peter MacCallum Cancer Centre’
3. Email the completed Referral Form to This email address is being protected from spambots. You need JavaScript enabled to view it. or fax to (03) 8559 7371

Contact

• Phone: (03) 8559 8632
• Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Related pages

Preventing Cancer with Medications (PCMed) Telehealth Service