Question

You are

. . . a physician’s assistant (PA) in the Genetic Counseling Clinic at Fulwood Medical Center.

Your patient is

. . . Mrs. Patricia Bennet, a 52-year-old office manager with two daughters, aged 30 and 25. Mrs. Bennett’s sister, aged 55, recently had a mastectomy for breast cancer and is now receiving chemotherapy. Their mother died of ovarian cancer in her late fifties.

1. Bennet wants to know her risk for breast or ovarian cancer, what she can do to prevent it, and what her daughters’ risks are? Write a medical report to provide the information needed for Patricia Bennet

Answer 1

Since the patient has hereditary connection of mother died with ovarian cancer this may be viewed in terms of Hereditary breast and ovarian cancer syndrome (HBOC).
This syndrome is caused by inherited mutations in the genes BRCA1 and BRCA2, as well as possibly some other genes that have not yet been found. This syndrome is linked to a high risk of breast cancer as well as ovarian, fallopian tube, and primary peritoneal cancers.
Mutations in BRCA1 and BRCA2 are also responsible for most inherited ovarian cancers. Mutations in BRCA1 and BRCA2 are about 10 times more common in those who are Ashkenazi Jewish than those in the general U.S. population.
The lifetime ovarian cancer risk for women with a BRCA1 mutation is estimated to be between 35% and 70%. This means that if 100 women had a BRCA1 mutation, between 35 and 70 of them would get ovarian cancer. For women with BRCA2 mutations the risk has been estimated to be between 10% and 30% by age 70. These mutations also increase the risks for primary peritoneal carcinoma and fallopian tube carcinoma.
In comparison, the ovarian cancer lifetime risk for the women in the general population is less than 2%.