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A 38-year-old woman was seen in the Gastrointestinal Cancer Genetics Clinic of this hospital because of a family history of breast and gastric cancer.
Approximately 15 months earlier, mild chronic gastrointestinal symptoms, including dyspepsia, heartburn, and midabdominal discomfort, increased in severity and began to occur daily. The symptoms did not resolve with antacid therapy. She had lost approximately 2.3 kg (5 lb) during this time, which she attributed to the stress of caring for her maternal aunt, who was dying of gastric cancer. Seven months before admission, an endoscopic examination of the upper gastrointestinal tract, performed at another hospital, was
Differential Diagnosis
Hereditary Breast Cancer Syndromes
Hereditary Gastric Cancer Syndromes
Colorectal Cancer Syndromes
Hereditary Diffuse Gastric Cancer Syndrome
Genetic Testing
Discussion of Management
Management of the Risk of Gastric Cancer
Prophylactic Gastrectomy
Technical Considerations
Morbidity and Mortality
Pathological Discussion
Anatomical Diagnosis
Source Information
From the Gastroenterology Unit (D.C.C.), the Division of Surgical Oncology and Department of Surgery (S.S.Y.), the Department of Pathology (G.Y.L.), and the Center for Cancer Risk Analysis (D.C.C., D.P.), Massachusetts General Hospital; and the Departments of Medicine (D.C.C.), Surgery (S.S.Y.), and Pathology (G.Y.L.), Harvard Medical School.
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