# Family history of ovarian cancer

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: BRCA1- and BRCA2-Associated Hereditary Breast and Ovarian Cancer - GeneReviews® - NCBI Bookshelf (NBK1247) - https://www.ncbi.nlm.nih.gov/books/NBK1247/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class AP66.02 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care
- Family history of ovarian cancer - disease-level clinical article (family-history-ovarian-cancer-full.txt)

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
FAMILY HISTORY OF OVARIAN CANCER
Sources: BRCA1- and BRCA2-Associated Hereditary Breast and Ovarian Cancer - GeneReviews® - NCBI
         Bookshelf (NBK1247) - https://www.ncbi.nlm.nih.gov/books/NBK1247/ · ICPC-3 (WONCA
         International Classification of Primary Care, 3rd edition) class AP66.02 - condition scope
         only, no dose · No dose - referral pathway, no medicine given in primary care
Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care,
               Family history of ovarian cancer - disease-level clinical article
               (family-history-ovarian-cancer-full.txt)  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (4)
    - Early-stage ovarian cancer is often symptom-free or so mild it gets overlooked
    - Nonspecific complaints include bloating, nausea, abdominal fullness or distension, early
      satiety, fatigue, altered bowel habits, urinary symptoms, back pain, and painful intercourse
      [abdominal distension · back pain · early satiety · fatigue · nausea · painful intercourse]
    - Abnormal uterine bleeding is not a typical presenting complaint of ovarian cancer  [abnormal
      uterine bleeding]
    - A rare paraneoplastic presentation is cerebellar degeneration causing unsteady gait, slurred
      speech, abnormal eye movements, and dizziness, which can precede the tumor being found by
      months or years  [dizziness · slurred speech]
  SIGNS - what you find (4)
    - An irregular, firm, fixed, nodular pelvic mass or ascites on exam should prompt imaging
      [ascites · pelvic mass]
    - A palpable pelvic mass, ascites, or reduced breath sounds from a pleural effusion can be found
      in advanced disease  [ascites · pelvic mass]
    - A firm nodule at the umbilicus is a rare finding from metastatic spread  [metastasis]
    - A sudden crop of new seborrheic keratoses can be a skin clue pointing to an occult malignancy
  TESTS (6)
    - BRCA1 and BRCA2 genetic testing is recommended for every woman diagnosed with epithelial
      ovarian cancer
    - CA-125 is raised in most advanced-stage cases but only in about half of early-stage disease,
      limiting its sensitivity
    - A CA-125 above 35 U/mL in a postmenopausal woman signals a high risk of malignancy
    - Transvaginal ultrasound findings suggesting malignancy include papillary or solid components,
      irregular shape, ascites, and strong color-Doppler flow
    - The O-RADS ultrasound scoring system's highest tier carries at least a 50 percent risk of
      malignancy and calls for prompt oncology referral
    - MRI can further characterize a mass when the ultrasound findings are equivocal or CA-125 is
      normal
  IF NOT THIS - what else fits (3)
    - Colon cancer and embryologic remnants are also on the differential for an adnexal mass
    - A peritoneal cyst or a retroperitoneal mass are also considered
    - Uterine fibroids and endometriosis round out the differential
  Source  StatPearls "Epithelial Ovarian Cancer" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    A risk factor, not a disease; the GP recognises it, discusses risk, and refers for
            genetic counselling/gynae-oncology assessment (e.g. BRCA testing) rather than
            prescribing. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      A risk factor, not a disease; the GP recognises it, discusses risk, and refers for
            genetic counselling/gynae-oncology assessment (e.g. BRCA testing) rather than
            prescribing.
   Caution  No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            The red flag symptoms of early ovarian cancer requiring urgent evaluation are persistent
            bloating, abdominal distention, early satiety, and pelvic masses.
            RED FLAG - Multiple affected relatives (ovarian and/or breast cancer), or a young age at
            a relative's diagnosis; personal symptoms (bloating, pelvic pain, early satiety) need
            urgent work-up.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
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