A 36 year old newly married woman has recently been diagnosed with right sided breast cancer. Her…

A 36 year old newly married woman has recently been diagnosed with right sided breast cancer. Her mother was treated for breast cancer at age 50 and a maternal aunty has a history of both breast cancer and ovarian cancer.

Is there likely to be a genetic inherited component? What factors point towards an inherited component?
Please describe the genes which could be involved or responsible? Please discuss the cancer risk these genes confer?
This woman is requesting genetic testing.

i. In your opinion, should this woman be tested? Please provide reasons to support this.
ii. What steps will you take to ensure that this woman is making an informed decision and that she is prepared for genetic testing and its results?
iii. This woman has tested positive. What medical management might she be offered?

What potential psychological issues may need to be addressed in this woman’s case?
This woman has 3 living sisters. How will you approach the issue of providing genetic testing for them?
i. 1 sister is found to carry the mutation gene. What screening procedure and follow-up will you recommend?
ii. 1 sister has a negative result. What is the significance of this? What follow-up will you recommend?
iii. 1 of the sisters has declined testing. What support would you offer this sister?