An Evaluation of FaHRAS Computer Programmes’ Utility in Family History Triage of Breast Cancer

Introduction: Rapid and appropriate family risk assessment and triage of patients are essential for patients presenting to a symptomatic breast unit and international criteria for review are well established. Family History Risk Assessment Software (FaHRAS) is a computerized program, involving different modalities of risk assessment, which is available but has not been widely assessed. Aims: This study evaluated the FaHRAS software scoring of family history risk. Its analysis was compared to multi-tool family history risk assessment models in a cohort of 353 patients on a historic family history waiting list. Methods: A recent published pilot study assessed and categorized family history risk in 353 patients on a historic family history waiting list, according to international guidelines including NICE criteria, Gail and IBIS risk estimates. The current study involved a reassessment of all 353 patients using the FaHRAS software program to determine its accuracy and ease of use. Patient demographics and time required to perform the analysis were documented. Results: FaHRAS identified 73 (20.7%) patients had an IBIS family history score of 17% or greater and 89 (25.2%) patients met the NICE guidelines criteria for management beyond primary care. In the previous study, this was 79 (22.4%) and 112 (31.7%) respectively. Using the largest denominator (NICE guidelines), 264/353 (74.8%) patients could be discharged to primary care using FaHRAS. Using this largest denominator, FaHRAS also identified a total of 28 (7.9%) patients requiring referral to tertiary care while the previous study identified 3 (0.8%). Conclusion: This is one of the first studies to validate FaHRAS, which is accurate and easy to use. FaHRAS system can enable clinicians to become more efficient gatekeepers to genetic services.