Devita, Hellman, and Rosenberg's Cancer

LWBK1006-14 LWW-Govindan-Review November 24, 2011 11:28

Chapter 14•Genetic Counseling 151

Question 14.5. Which of the following factors suggest that a family may have hereditary

cancer?

A. Young age at diagnosis

B. Bilateral cancer in an affected family member

C. Multiple affected generations

D. All of the above

Refer to the following pedigree for Questions 14.6 to 14.8.

“Stomach” cancer

I-2

I-1

d. MVA

II-1

d. 19

Gastric Cancer

II-2

Diffuse Gastric

Cancer

dx. 52

III-1

Olivia 38

III-2

42

III-3

46

III-4

Colon Cancer

dx. 64

II-3

d. 45

Lobular Breast

Cancer

dx. 40

II-4

II-5

I

II

III

Olivia is a 38-year-old healthy woman who presents to her primary

care physician concerned about her family history of cancer. She has

no chronic health concerns. Both her mother’s and father’s family are

of Ashkenazi Jewish ancestry. Olivia pursues an evaluation with a

clinical geneticist for assessment and genetic testing.

Question 14.6. The clinical geneticist diagnoses the family with which cancer predispo-

sition syndrome?

A. HNPCC syndrome

B. Hereditary breast cancer 1 (BRCA1) syndrome

C. Li-Fraumeni syndrome

D. Hereditary BRCA2 syndrome

E. None of the above

Question 14.7. Which of the following features is NOT consistent with hereditary cancer

in the family depicted?

A. Multiple affected family members

B. Lobular breast cancer and diffuse gastric cancer pathology

C. Ashkenazi Jewish heritage

D. Affected family member diagnosed at a young age