Question 1

Question

A 38-year-old woman with BRCA1 mutation and strong family history of breast and ovarian cancer (mother and sister both affected) undergoes bilateral prophylactic mastectomy. Final pathology unexpectedly reveals a 0.6 cm focus of ductal carcinoma in situ (DCIS) in the right breast, high-grade, with clear margins. She has not yet undergone risk-reducing salpingo-oophorectomy. She desires breast reconstruction. Evaluate the comprehensive management strategy.

Accepted Answer

No additional breast surgery needed; proceed with immediate reconstruction and discuss oophorectomy timing

Answer

Radiation therapy to mastectomy site; delayed reconstruction; oophorectomy after radiation

Answer

Observation of surgical site; proceed with reconstruction; defer oophorectomy until age 40

Answer

Re-excision to wider margins; delayed reconstruction after confirming no invasion; immediate oophorectomy

Answer

Genetic counseling; additional oncologic surgery consultation; defer all additional procedures

Oncologic Surgery Principles — MCQs

Oncologic Surgery Principles — MCQs

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