**Core Concept**
Women with a mutation in the BRCA-1 gene have a significantly increased risk of developing breast carcinoma due to impaired DNA repair mechanisms, particularly in the homologous recombination pathway. This genetic predisposition leads to an accumulation of genetic alterations, ultimately resulting in cancer. The BRCA-1 gene product, a tumor suppressor protein, plays a crucial role in maintaining genomic stability.

**Why the Correct Answer is Right**
The presence of a BRCA-1 mutation is associated with a substantially elevated risk of breast cancer. Studies have consistently shown that women with a BRCA-1 mutation have a 60-70% lifetime risk of developing breast cancer, compared to less than 1% in the general population. This increased risk is attributed to the defective DNA repair mechanisms, which allow harmful genetic mutations to accumulate and persist in breast cells.

**Why Each Wrong Option is Incorrect**
**Option A:** 10% is an underestimation of the increased risk associated with BRCA-1 mutations. While some studies may report a lower risk, the majority of evidence supports a significantly higher risk.
**Option B:** 20% is still an underestimate, as the actual risk is nearly three times higher. This option may be chosen by those who are not familiar with the magnitude of the increased risk.
**Option C:** 40% is closer to the actual risk but still does not accurately reflect the increased risk associated with BRCA-1 mutations.

**Clinical Pearl / High-Yield Fact**
Women with a BRCA-1 mutation should be advised to undergo regular breast cancer screening, including annual mammograms and clinical breast exams, starting at age 25. They may also consider prophylactic mastectomy or other risk-reducing strategies to minimize their risk of developing breast cancer.

**✓ Correct Answer: D. 60**