E2251. Improving Eligible Patient Identification and Program Enrollment for Organized Enhanced High Risk Breast Screening in Ontario
  1. Ingrid Ambus; North York General Hospital
  2. Petrina Causer; North York General Hospital
  3. Jessica Wilson; North York General Hospital
Women with a =25% lifetime risk for breast cancer can access enhanced screening including breast MRI, genetic counselling, and opportunities for risk reduction when enrolled in the High Risk Ontario Breast Screening Program (HR-OBSP). To be enrolled, a physician must identify a woman as high-risk and refer for assessment. Barriers to assessment include lack of physician awareness about the program, and patient failure to report relevant changes in her family cancer history. It is estimated that <1/3 of eligible provincial women are enrolled in the HR-OBSP.

Materials and Methods:
The Medical Imaging (MI) and Genetics teams created a process identifying eligible high-risk patients presenting for mammographic screening. The mammography technologist intake questionnaire was modified to include the HR-OBSP referral criteria. Patients were flagged as eligible for HR-OBSP assessment and with their consent, MI notified Genetics. The most responsible physician (MRP) was contacted by fax, communicating their patient was eligible for formal HR-OBSP assessment and outlining the referral process.

In the first 9 months, 217 notifications were sent to the MRPs, from 6270 screening mammograms. Genetics referrals were received on 129 (59%) of these patients, and 76 were assessed. Of these, 11 were eligible for HR-OBSP, accounting for 6.5% of all eligible HR-OBSP assessments performed by Genetics during that time period. The overall number of OBSP referrals increased by 20% from the same time the previous year.

This initiative raised MRPs awareness about the HR-OBSP, and increased the number of high-risk women who had access to enhanced screening.