A 66-year-old woman presents to your office following a recent lab report showing elevated CA-125 levels. Although she has no overt symptoms of malignancy, she is understandably concerned about the possibility of cancer given her age. You review her history and explain that CA-125 is a tumor marker most commonly associated with certain gynecologic cancers. Question: Which of the following conditions is most strongly associated with elevated CA-125 levels?
A 42-year-old woman visits your gynecology clinic after receiving genetic testing results that confirm she carries a BRCA1 mutation. Her family history is concerning—her mother was diagnosed with ovarian cancer at age 58 and her maternal aunt developed breast cancer at age 50. Despite having no personal history of cancer or significant medical issues and being asymptomatic, she is understandably anxious about her risk. She is seeking advice on evidence-based strategies to reduce her risk of developing ovarian cancer. Question: Which of the following strategies is most effective at reducing ovarian cancer risk in high-risk women with BRCA mutations?
A 42-year-old woman visits her gynecologist for a routine check-up, expressing concern about her family history of ovarian and breast cancer. Her mother was diagnosed with ovarian cancer at age 58, and her maternal aunt developed breast cancer at age 50. Although she has no personal history of cancer or significant medical issues and is currently asymptomatic, she is worried about her own risk and seeks advice on preventive strategies. Which of the following is considered a major risk factor for ovarian cancer?
A 57-year-old woman comes in for her annual well-woman exam, expressing concerns about her risk of ovarian cancer. She has a strong family history of ovarian cancer—both her mother and sister were diagnosed in their 50s. Her personal history includes menarche at age 11 and menopause at age 53. She smokes one pack of cigarettes daily and has a BMI of 32. Given her concerns and family history, she asks which of her risk factors most strongly predisposes her to ovarian cancer. Question: Which of the following is the strongest risk factor for ovarian cancer in this patient?
A 26-year-old female patient comes to your office for her annual physical examination. Concerned about ovarian cancer after reading that it is the leading cause of death among gynecologic malignancies in the United States, she requests additional testing “just to be safe.” Her medical history is reassuring: menarche at age 14, married with three children whom she breastfed, no family history of breast or ovarian cancer, and she has used oral contraceptives for two years followed by tubal ligation one month ago. She is asymptomatic and in good health overall, yet she insists on undergoing screening to rule out ovarian cancer. Question: Which of the following is an effective screening test or program for ovarian cancer in this asymptomatic, low-risk patient?
A 68-year-old woman presents with complaints of abdominal discomfort, significant weight loss, and a noticeable mass around her navel. On physical examination, a firm, palpable nodule is observed at the umbilicus. Further imaging and evaluation raise concerns for an advanced intra-abdominal malignancy with metastatic spread. Question: The umbilical nodularity seen in this patient is colloquially known as:
A 55-year-old Hispanic woman presents for her annual gynecologic exam. Her menarche was at age 12 and her menopause was at 52. She is concerned about her risk of ovarian cancer because her mother was diagnosed with ovarian cancer at age 60, and her older sister was recently diagnosed with breast cancer associated with a BRCA1 mutation. She smokes one pack of cigarettes every day. She is eager to understand which of her risk factors is most significant for developing ovarian cancer. Question: The most significant risk factor for developing ovarian cancer is:
A 67-year-old woman presents with complaints of persistent indigestion, abdominal discomfort, bloating, and early satiety. Over the past four weeks, she has experienced a 10-pound weight loss and worsening pelvic pressure. Her medical history is notable for long-term hormone replacement therapy (HRT) to manage menopausal symptoms. She had menarche at age 10 and reached menopause at age 54. She has one child, born when she was 32. Her family history is significant: her mother died of breast cancer associated with a BRCA1 mutation, and her older sister succumbed to ovarian cancer linked to a RAD51C mutation. Additionally, she smokes about 6 cigarettes a day and is of Ashkenazi Jewish descent. On examination, a palpable abdominal mass and ascites are noted, and CT imaging reveals a complex adnexal mass with ascitic fluid and umbilical nodularity. Question: Which of the following factors in her history increase her risk for ovarian cancer?
A 58-year-old woman with a known diagnosis of endometrial cancer undergoes comprehensive surgical staging and imaging studies. The workup reveals that the cancer has extended to involve the vagina, but there is no evidence of distant metastasis. Which FIGO stage corresponds to endometrial cancer with vaginal involvement but no distant metastasis?
