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A 40-Year-Old Woman Has a Routine Gynecologic Examination

Question 19

Multiple Choice

A 40-year-old woman has a routine gynecologic examination. At the age of 32 years, she gave birth to twins after receiving fertility drugs. She has just seen a television program on ovarian cancer, and is concerned because previous use of fertility drugs and a family history of ovarian cancer were mentioned as possible risk factors. Her mother developed endometrial cancer at 56 years, and a paternal uncle was diagnosed with a type of lymphoma at 60 years. She has one older sister with hypertension and one younger brother who is healthy. Results of her pelvic examination are unremarkable, but she asks what additional tests she should have to look for ovarian cancer in the early stages that cannot be detected by physical examination. What is the most appropriate management for this patient?


A) Blood test for CA-125
B) Rectovaginal pelvic examination in 1 year
C) Transvaginal ultrasound
D) Screening test for BRCA-1 and BRCA-2

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