Discussion board

Discussion board

Question 1A

48-year-old woman presents to your clinic for a new patient visit. She has a personal history of HTN and anxiety which are both managed well with medications. Her family history is notable for her mother dying of breast cancer at age 55 and two aunts who both were treated with mastectomies and chemotherapy.

Her exam is unremarkable including a breast and gynecologic exam.

How would your discussion go regarding screening?

Would you recommend a mammogram or an MRI in this patient? Is she “high risk” or standard risk?

Would you recommend screening for BRCA1/2 or would you refer her to a geneticist for such screening?

What is a BI-RADS score and what are the six scores?

What are you personal thoughts on self-examination? Does it help? Does it do more harm than good?


A 21 year old girl comes in to your office for a well visit/annual exam. She is otherwise healthy and a junior in college studying nursing. She takes no medications, drinks socially, doesn’t smoke anything or use illicit drugs. She currently has no symptoms: no pain with urination/sexual activity/vaginal discharge.

She is sexually active. She occasionally uses condoms and is taking a combined estrogen/progesterone OCP for contraception. She has had four male partners in the last year and has been pregnant once, with an abortion at age 19. She does not think she has had a pap smear, although she did have pelvic exams as a teen. She was not vaccinated against HPV because “her parents didn’t believe in it”.

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