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Barrett's Surveillance Interval — RACP Adult Medicine MCQ

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HardGastroenterology & HepatologyBarrett's Surveillance IntervalRACP Adult Medicine

A 36-year-old BRCA1 carrier has completed treatment for unilateral breast cancer and does not currently want contralateral mastectomy. She has completed childbearing. Which risk-management discussion has the greatest evidence for reducing tubo-ovarian cancer risk?

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Correct answer: A — Risk-reducing bilateral salpingo-oophorectomy with menopause, fertility and pathology planning

Explanation lettering: D = shown as A · A = shown as B · B = shown as D

D is correct. BRCA1 carriers who have completed childbearing should discuss risk-reducing salpingo-oophorectomy, with menopausal and pathology planning. A and B have not shown equivalent mortality prevention. C delayed oophorectomy is investigational outside trials. E hysterectomy alone leaves the principal tubo-ovarian risk organs in situ.

Reference: eviQ, BRCA1 or BRCA2 risk management (female): https://www.eviq.org.au/cancer-genetics/adult/risk-management/3814-brca1-or-brca2-risk-management-female