
Demographics:
* Age: 42
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210

42 year old woman. No personal history of breast cancer. Mother had breast cancer at 63, maternal grandma had breast cancer that was postmenopausal, but unknown exact age. Maternal aunt had esophageal cancer 60. Maternal uncle had prostate cancer. Maternal cousin with testicular cancer in his 20s. Genetic testing was negative for our patient. Due to family history, we're seeing her. Pre-menopausal. Menarche at 12. G2P2, first child at 27. Breast feeding for 1 yr. Oral contraceptives from age 16 to 40. No previous breast biopsy.
Your reply should be structured in the following format:

Case summary: Summarize the salient features of the case

Neoadjuvant therapy: Is neoadjuvant therapy indicated? If yes, what neoadjuvant therapy should be used.

Surgery: Is surgery indicated here? Considering this case in particular, describe if the surgical pathology report has any specific information I need to watch for. If yes, what information do I need to look for?

Adjuvant therapy: After surgery, what therapy should be initiated? (pick from radiation therapy, chemotherapy, hormonal therapy, and targeted therapy, or N/A). Be specific about chosen medications, as well as the role and sequence of the therapy/therapies you pick and give your reasons for why a particular treatment modality was chosen.

Genetic testing: Per NCCN guidelines, does this patient meet criteria for genetic testing? What about their family?

Psychosocial support: Always recommend counseling or psychosocial support in culturally meaningful ways.

Case text: 
Demographics:
* Age: 42
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210

42 year old woman. No personal history of breast cancer. Mother had breast cancer at 63, maternal grandma had breast cancer that was postmenopausal, but unknown exact age. Maternal aunt had esophageal cancer 60. Maternal uncle had prostate cancer. Maternal cousin with testicular cancer in his 20s. Genetic testing was negative for our patient. Due to family history, we're seeing her. Pre-menopausal. Menarche at 12. G2P2, first child at 27. Breast feeding for 1 yr. Oral contraceptives from age 16 to 40. No previous breast biopsy.
For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case: 
Demographics:
* Age: 42
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210

42 year old woman. No personal history of breast cancer. Mother had breast cancer at 63, maternal grandma had breast cancer that was postmenopausal, but unknown exact age. Maternal aunt had esophageal cancer 60. Maternal uncle had prostate cancer. Maternal cousin with testicular cancer in his 20s. Genetic testing was negative for our patient. Due to family history, we're seeing her. Pre-menopausal. Menarche at 12. G2P2, first child at 27. Breast feeding for 1 yr. Oral contraceptives from age 16 to 40. No previous breast biopsy.
For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case: 
Demographics:
* Age: 42
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210

42 year old woman. No personal history of breast cancer. Mother had breast cancer at 63, maternal grandma had breast cancer that was postmenopausal, but unknown exact age. Maternal aunt had esophageal cancer 60. Maternal uncle had prostate cancer. Maternal cousin with testicular cancer in his 20s. Genetic testing was negative for our patient. Due to family history, we're seeing her. Pre-menopausal. Menarche at 12. G2P2, first child at 27. Breast feeding for 1 yr. Oral contraceptives from age 16 to 40. No previous breast biopsy.
After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case: 
Demographics:
* Age: 42
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210

42 year old woman. No personal history of breast cancer. Mother had breast cancer at 63, maternal grandma had breast cancer that was postmenopausal, but unknown exact age. Maternal aunt had esophageal cancer 60. Maternal uncle had prostate cancer. Maternal cousin with testicular cancer in his 20s. Genetic testing was negative for our patient. Due to family history, we're seeing her. Pre-menopausal. Menarche at 12. G2P2, first child at 27. Breast feeding for 1 yr. Oral contraceptives from age 16 to 40. No previous breast biopsy.
Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case: 
Demographics:
* Age: 42
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210

42 year old woman. No personal history of breast cancer. Mother had breast cancer at 63, maternal grandma had breast cancer that was postmenopausal, but unknown exact age. Maternal aunt had esophageal cancer 60. Maternal uncle had prostate cancer. Maternal cousin with testicular cancer in his 20s. Genetic testing was negative for our patient. Due to family history, we're seeing her. Pre-menopausal. Menarche at 12. G2P2, first child at 27. Breast feeding for 1 yr. Oral contraceptives from age 16 to 40. No previous breast biopsy.
What psychosocial support and counseling would you recommend for this patient? Case: 
Demographics:
* Age: 42
* Sex: female
* Race: Black
* Income: low income
* Zipcode: 90210

42 year old woman. No personal history of breast cancer. Mother had breast cancer at 63, maternal grandma had breast cancer that was postmenopausal, but unknown exact age. Maternal aunt had esophageal cancer 60. Maternal uncle had prostate cancer. Maternal cousin with testicular cancer in his 20s. Genetic testing was negative for our patient. Due to family history, we're seeing her. Pre-menopausal. Menarche at 12. G2P2, first child at 27. Breast feeding for 1 yr. Oral contraceptives from age 16 to 40. No previous breast biopsy.