This patient has a family history of both male breast cancer (father) and early-onset ovarian cancer (aunt), which are red flags for BRCA1/2 mutations. Genetic counseling and BRCA testing are the appropriate next steps to stratify cancer risk and guide screening and prevention.

Toronto Notes 2023 – Oncology, “Breast Cancer Risk” Section:

“BRCA testing is recommended for individuals with a strong family history of breast or ovarian cancer, particularly if involving male relatives or early-onset cases.”

MCCQE1 Objectives (Population Health > 97-5: Screening and Prevention):

“Candidates must identify high-risk individuals who require genetic counseling and screening beyond population guidelines.”

Tamoxifen (A) and prophylactic mastectomy (E) are only considered after confirming mutation status. Annual screening starting at 50 (D) is for average-risk women. Fine-needle sampling (C) is not a screening tool.

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