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A 37 year old woman comes to the physician because she is concerned about her risk for breast and ovarian cancer. She has no history of serious illness and takes no medications. Menses occur at regular 28 day intervals. She has two uncomplicated spontaneous vaginal deliveries. She breast-fed both children for 1 year. The patient is sexually active with her husband. Her mother, grandmother, and older sister died of ovarial cancer in their 40s. Her maternal aunt was treated for breast cancer and underwent prophylactic oophorectomy after genetic testing showed a BRCA1 mutation. Physical and pelvic exams show no abnormalities. The patient asks if there is anything that will help decrease her risk for ovarian cancer. Which of the following is the most appropriate recommendation?
A. Annual measurement of serum CEA concentration if genetic testing shows BRCA1 mutation
B. Annual pelvic exam if genetic testing shows BRCA1 mutation.
C. Laparoscopy to evaluate the ovaries if genetic testing shows BRCA1 mutation
D. Prophylactic oophorectomy of genetic testing shows BRCA 1 Mutation
E. Nothing is indicated


D - very high risk


Thats Right. grin







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