A 27-year-old woman requests a mammogram because both her mother and sister died of metastatic breast cancer before 40 years of age. Which of the following would add to this patient’s risk factors for breast cancer?
**Core Concept**
The patient is a 27-year-old woman with a strong family history of breast cancer, specifically her mother and sister dying of metastatic breast cancer before 40 years of age. This scenario describes a high-risk family history for breast cancer, often associated with genetic mutations such as BRCA1 and BRCA2.
**Why the Correct Answer is Right**
The correct answer would add to this patient's risk factors for breast cancer by further increasing her likelihood of carrying a harmful genetic mutation. The addition of a first-degree relative (mother or sister) with breast cancer at a young age significantly elevates the risk. The correct answer would be another first-degree relative with breast cancer at a young age, as this would increase the likelihood of a shared genetic mutation.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option does not specify a first-degree relative with breast cancer at a young age, making it less likely to increase the patient's risk factors.
* **Option B:** A second-degree relative (grandmother or aunt) with breast cancer at a young age does not significantly increase the patient's risk factors.
* **Option D:** A family history of ovarian cancer is not directly related to breast cancer risk, although some genetic mutations, such as BRCA1 and BRCA2, increase the risk of both breast and ovarian cancer.
**Clinical Pearl / High-Yield Fact**
Remember that a family history of breast cancer before 40 years of age in first-degree relatives significantly increases a woman's risk for breast cancer. A strong family history, combined with other risk factors, may warrant consideration of genetic testing for BRCA1 and BRCA2 mutations.
**Correct Answer:** C.