O&G Cases · Gynae-oncology — hereditary cancer
Counselling a confirmed BRCA1 carrier — communication and counselling station
Communication and counselling station: a confirmed BRCA1 carrier needs risk counselling, a recommendation for risk-reducing salpingo-oophorectomy with its timing and limits, discussion of surgical menopause and HRT, and cascade testing for her children. Tests the candidate's ability to convert risk figures into plain language, communicate uncertainty honestly, and structure a shared decision. Includes assessor key and marking domains.
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Station brief
You are the registrar in the familial cancer clinic. The patient has her result and three clear questions. You have 12 minutes to: give her an honest, sourced estimate of her ovarian cancer risk; recommend risk-reducing surgery with its timing, what it prevents and does not prevent; address surgical menopause and hormone replacement; and explain cascade testing for her children. A shared decision is the goal, not a monologue. [11]
References4ShowHide
- [1]Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers JAMA, 2017.PMID 28632866
- [3]Finch AP, Lubinski J, Møller P, et al. Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation J Clin Oncol, 2014.PMID 24567435
- [10]Stanciu PI, Ind TEJ, Barton DPJ, et al. Development of peritoneal carcinoma in women diagnosed with serous tubal intraepithelial carcinoma (STIC) following risk-reducing salpingo-oophorectomy (RRSO) J Ovarian Res, 2019.PMID 31128592
- [11]Sabiani L, Barrou J, Mathis J, Eisinger F How to manage BRCA mutation carriers? Horm Mol Biol Clin Investig, 2020.PMID 32459193