Expanding role of the breast advanced nurse practitioner: mainstream pathway for genetic testing.

Genomic panel testing is increasingly being undertaken in the breast specialty to enhance diagnosis, treatment and surveillance recommendations. With increasing numbers of patients becoming eligible for testing, it is useful for advanced nurse practitioners (ANPs) and clinical nurse specialists (CNSs) who possess a relevant skill set to develop their abilities to include genomic mainstream panel testing counselling and to create a service to provide this. Within the breast specialty, ANPs and CNSs who undertake family history assessment as part of their role are perfectly placed to lead on this service and enhance their scope of practice safely and efficiently. Development of this service within the surgical specialty can enhance patients' experience owing to continuity of care, reduced hospital visits and a quicker turnaround time for results. Potential issues with developing the service include ensuring appropriate availability of trained staff, centralisation of referrals and providing education and awareness to the wider multidisciplinary team. This personal experience account of a service development may help others identify opportunities for development in their teams.