Taking The Family History

In most instances of hereditary EC, the family history, when extended through three generations in the modified nuclear pedigree (Fig. 3), will demonstrate patterns of cancer clustering, which merit the consideration of a hereditary cancer syndrome. Details about the proband's cancer history and the histories of parents, siblings, progeny, and both paternal and maternal lineages, including cancer of all anatomical sites with pathology documentation whenever possible, will serve to confirm the initial impression. Extended pedigree analysis is essential and must include parents, grandparents, aunts, and uncles who are likely to be older individuals who, having passed through the cancer risk age will be genetically more informative.

Ivanovich et al. (15) analyzed the process for collecting and verifying reported cancer family histories and concurrently evaluating inaccuracies from a series of women with EC. They obtained detailed family histories from 80 women. Medical records were obtained to verify cancer reporting. Findings showed that medical records were more likely to be obtained when the cancer-affected relative was living and closely related to the study participant in whom the cancer type was already known. Expectedly, the success in retrieving medical records decreased with increasing age of the records (p < 0.001). Inaccurate reporting was identified in 28.6% of verified cancers. In addition, there was a significantly higher number of inaccurate reports among second-degree and third-degree relatives as opposed to first-degree relatives (p = 0.02). The authors concluded that additional studies to improve record collection efficiency and to identify cancer reporting accuracy are needed among the general research community.

Fig. 4. Prototype endometrioid carcinoma.
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