
Demographics:
* Age: 33
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027

33 year old woman, she has a family history of paternal grandfather with prostate cancer and kidney cancer. She has had multiple biopsies on the left: One was benign, showed ductal hyperplasia and pseudoangiomatous stromal hyperplasia. Next biopsy showed Lobular carcinoma in situ (LCIS) and sclerosing papilloma and atypical lobular hyperplasia (ALH). Genetic testing was negative. Another biopsy, showed ALH and LCIS as well as radial scar on the left side. She finally had an excisional biopsy where they removed complex sclerosing lesions and 1-mm LCIS.
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: 33
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027

33 year old woman, she has a family history of paternal grandfather with prostate cancer and kidney cancer. She has had multiple biopsies on the left: One was benign, showed ductal hyperplasia and pseudoangiomatous stromal hyperplasia. Next biopsy showed Lobular carcinoma in situ (LCIS) and sclerosing papilloma and atypical lobular hyperplasia (ALH). Genetic testing was negative. Another biopsy, showed ALH and LCIS as well as radial scar on the left side. She finally had an excisional biopsy where they removed complex sclerosing lesions and 1-mm LCIS.
For this case, is neoadjuvant therapy indicated? If yes, what specific neoadjuvant therapy should be used? Case: 
Demographics:
* Age: 33
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027

33 year old woman, she has a family history of paternal grandfather with prostate cancer and kidney cancer. She has had multiple biopsies on the left: One was benign, showed ductal hyperplasia and pseudoangiomatous stromal hyperplasia. Next biopsy showed Lobular carcinoma in situ (LCIS) and sclerosing papilloma and atypical lobular hyperplasia (ALH). Genetic testing was negative. Another biopsy, showed ALH and LCIS as well as radial scar on the left side. She finally had an excisional biopsy where they removed complex sclerosing lesions and 1-mm LCIS.
For this case, what surgical approach is indicated? What specific pathology findings should I watch for? Case: 
Demographics:
* Age: 33
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027

33 year old woman, she has a family history of paternal grandfather with prostate cancer and kidney cancer. She has had multiple biopsies on the left: One was benign, showed ductal hyperplasia and pseudoangiomatous stromal hyperplasia. Next biopsy showed Lobular carcinoma in situ (LCIS) and sclerosing papilloma and atypical lobular hyperplasia (ALH). Genetic testing was negative. Another biopsy, showed ALH and LCIS as well as radial scar on the left side. She finally had an excisional biopsy where they removed complex sclerosing lesions and 1-mm LCIS.
After surgery, what adjuvant therapy should be initiated for this case? Be specific about medications and sequence. Case: 
Demographics:
* Age: 33
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027

33 year old woman, she has a family history of paternal grandfather with prostate cancer and kidney cancer. She has had multiple biopsies on the left: One was benign, showed ductal hyperplasia and pseudoangiomatous stromal hyperplasia. Next biopsy showed Lobular carcinoma in situ (LCIS) and sclerosing papilloma and atypical lobular hyperplasia (ALH). Genetic testing was negative. Another biopsy, showed ALH and LCIS as well as radial scar on the left side. She finally had an excisional biopsy where they removed complex sclerosing lesions and 1-mm LCIS.
Based on NCCN guidelines, does this patient meet criteria for genetic testing? What about their family? Case: 
Demographics:
* Age: 33
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027

33 year old woman, she has a family history of paternal grandfather with prostate cancer and kidney cancer. She has had multiple biopsies on the left: One was benign, showed ductal hyperplasia and pseudoangiomatous stromal hyperplasia. Next biopsy showed Lobular carcinoma in situ (LCIS) and sclerosing papilloma and atypical lobular hyperplasia (ALH). Genetic testing was negative. Another biopsy, showed ALH and LCIS as well as radial scar on the left side. She finally had an excisional biopsy where they removed complex sclerosing lesions and 1-mm LCIS.
What psychosocial support and counseling would you recommend for this patient? Case: 
Demographics:
* Age: 33
* Sex: female
* Race: White
* Income: middle income
* Zipcode: 10027

33 year old woman, she has a family history of paternal grandfather with prostate cancer and kidney cancer. She has had multiple biopsies on the left: One was benign, showed ductal hyperplasia and pseudoangiomatous stromal hyperplasia. Next biopsy showed Lobular carcinoma in situ (LCIS) and sclerosing papilloma and atypical lobular hyperplasia (ALH). Genetic testing was negative. Another biopsy, showed ALH and LCIS as well as radial scar on the left side. She finally had an excisional biopsy where they removed complex sclerosing lesions and 1-mm LCIS.