Devita, Hellman, and Rosenberg's Cancer

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

Chapter 14•Genetic Counseling 153

Refer to the following pedigree for Questions 14.11 and 14.12.

Breast Cancer

I-2

Ovarian Cancer

dx. 72

I-3

70

II-4

75

II-2

71

II-1

42

III-1

Breast Cancer

dx. 39

III-2

36

Pauline

III-3

d. 39

Breast Cancer

dx. 38

III-4

d. 45

Breast Cancer

dx. 42

II-3

I-1

I

II

III

Question 14.11. Pauline, depicted by the arrow, is a healthy 36-year-old woman who

presents to her gynecologist concerned about her breast cancer risk. She

requests genetic testing. No other family member has undergone genetic

testing. The gynecologist ordersBRCA1andBRCA2gene testing. No

mutation is identified. Which of the following statements is the correct

interpretation of Pauline’s testing?

A. Pauline’s test result is a true negative.

B. Pauline’s test result is an unknown variant.

C. Pauline’s test result is uninformative.

D. Pauline’s test result is positive.

Question 14.12. Pauline’s sister, individual III-2, is currently undergoing neoadjuvant

chemotherapy for an aggressive ductal carcinoma of the breast. She is

not interested in pursuing genetic testing at this time given the demands

of her treatment. What breast health screening recommendations do you

make for Pauline given her negative genetic testing?

A. Mammography beginning at age 40 years

B. Mammography and breast ultrasound beginning at age 40 years

C. Mammography and breast ultrasound beginning now

D. Mammography and breast MRI beginning now

Question 14.13. Which of the following malignancies does not have a significant increase

in incidence among patients with Lynch syndrome?

A. Colon cancer

B. Cervical cancer

C. Ovarian cancer

D. Endometrial cancer