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Unit 5 > Topic 55: Ovarian Neoplasms ACOG
Questions With Complete Solutions 2025
35-year-old African-American G0 woman has a family
history of ovarian cancer. Her mother was diagnosed
with ovarian cancer at age 50 and is in remission. The
patient had onset of menarche at age 14. She has used
oral contraceptives for a total of 10 years. She smokes
one to two packs of cigarettes per week. The patient
had a LEEP for treatment of cervical dysplasia. Which of
the following places the patient at greatest risk for
developing ovarian cancer?
A. African American race
B. Family history of ovarian cancer
C. Gravidity
D. Late age at menarche
E. Smoking - ....ANSWER ....✔✔ B
Correct! The events leading to the development of
ovarian cancer are unknown. Epidemiologic studies,
however, have identified endocrine, environmental and
genetic factors as important in the carcinogenesis of
ovarian cancer. The established risk factors include
nulliparity, family history, early menarche and late
,2|Page
menopause, white race, increasing age and residence in
North America and Northern Europe. Smoking has not
been demonstrated to be associated with an increased
risk of ovarian cancer.
An 18-year-old nulliparous woman presents to discuss
contraception. Her best friend's mother was just
diagnosed with ovarian cancer. The patient is healthy
and does not have any significant medical history. She
does not have a family history of ovarian, breast or any
other malignancies. She uses condoms for birth control.
She would like to know what she can do to minimize her
risk for developing ovarian cancer. Which of the
following recommendations is the most appropriate for
this patient?
A. Begin childbearing now
B. Use an intrauterine device
C. Use oral contraceptives until she is ready to have
children
D. Have a prophylactic oophorectomy once
childbearing is complete
E. There are no proven means to reduce the risk of
ovarian cancer - ....ANSWER ....✔✔ C
Correct! A woman's risk for development of ovarian
cancer during her lifetime is approximately 1%. Factors
associated with development of ovarian cancer include
,3|Page
low parity and delayed childbearing. Long-term
suppression of ovulation appears to be protective
against the development of ovarian cancer. Oral
contraceptives that cause anovulation appear to provide
protection against the development of ovarian cancer.
Five years cumulative use decreases the lifetime risk by
one-half. Prophylactic oophorectomy is not a practical
choice for this patient with no family history, even once
she completes childbearing. This option might be
considered for a woman with a strong family history and
the BRCA mutation.
A 25-year-old G0 woman presents for a refill on oral
contraceptives. She has a history of recurrent ovarian
cysts. She has no significant medical or surgical history.
Her grandmother was recently diagnosed with ovarian
cancer and her mother is undergoing treatment for
metastatic breast cancer. The patient is interested in
assessing her risk for ovarian cancer susceptibility.
Which of the following is the most appropriate test to
offer this patient?
A. Annual CA125 levels
B. Annual pelvic ultrasound
C. Genetic testing of BRCA 1 and 2 mutations on the
patient's mother
E. Check the patient for p53 mutation
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D. Genetic testing of BRCA 1 and 2 mutations on the
patient's grandmother - ....ANSWER ....✔✔ Incorrect!
Correct answer is C. BRCA1 and BRCA2 mutations are
typically seen in cases of hereditary ovarian cancers.
Overall, it has been estimated that inherited BRCA1 and
BRCA2 mutations account for 5 to 10 percent of breast
cancers and 10 to 15 percent of ovarian cancers among
white women in the United States. Given this family
history, it is highly likely that a mutation is present, and
the affected individual (proband) should be tested if still
alive. Because breast cancers are part of the BRCA
mutation, the affected mother should be tested. Routine
screening for ovarian cancer has not been established.
A 25-year-old G1P1 woman comes in for her annual
health maintenance examination. She has intermittent
left lower quadrant discomfort. She has regular menses
every 30 days and uses a diaphragm for birth control.
Her last menstrual period was approximately three
weeks ago. Her physical examination is notable for a 3
x 5 cm left adnexal mass. Ultrasound shows a unilocular
simple cyst. Which of the following is the most likely
diagnosis in this patient?
A. Endometrioma
B. Functional ovarian cyst
C. Mucinous cystadenoma
D. Serous cystadenoma
Unit 5 > Topic 55: Ovarian Neoplasms ACOG
Questions With Complete Solutions 2025
35-year-old African-American G0 woman has a family
history of ovarian cancer. Her mother was diagnosed
with ovarian cancer at age 50 and is in remission. The
patient had onset of menarche at age 14. She has used
oral contraceptives for a total of 10 years. She smokes
one to two packs of cigarettes per week. The patient
had a LEEP for treatment of cervical dysplasia. Which of
the following places the patient at greatest risk for
developing ovarian cancer?
A. African American race
B. Family history of ovarian cancer
C. Gravidity
D. Late age at menarche
E. Smoking - ....ANSWER ....✔✔ B
Correct! The events leading to the development of
ovarian cancer are unknown. Epidemiologic studies,
however, have identified endocrine, environmental and
genetic factors as important in the carcinogenesis of
ovarian cancer. The established risk factors include
nulliparity, family history, early menarche and late
,2|Page
menopause, white race, increasing age and residence in
North America and Northern Europe. Smoking has not
been demonstrated to be associated with an increased
risk of ovarian cancer.
An 18-year-old nulliparous woman presents to discuss
contraception. Her best friend's mother was just
diagnosed with ovarian cancer. The patient is healthy
and does not have any significant medical history. She
does not have a family history of ovarian, breast or any
other malignancies. She uses condoms for birth control.
She would like to know what she can do to minimize her
risk for developing ovarian cancer. Which of the
following recommendations is the most appropriate for
this patient?
A. Begin childbearing now
B. Use an intrauterine device
C. Use oral contraceptives until she is ready to have
children
D. Have a prophylactic oophorectomy once
childbearing is complete
E. There are no proven means to reduce the risk of
ovarian cancer - ....ANSWER ....✔✔ C
Correct! A woman's risk for development of ovarian
cancer during her lifetime is approximately 1%. Factors
associated with development of ovarian cancer include
,3|Page
low parity and delayed childbearing. Long-term
suppression of ovulation appears to be protective
against the development of ovarian cancer. Oral
contraceptives that cause anovulation appear to provide
protection against the development of ovarian cancer.
Five years cumulative use decreases the lifetime risk by
one-half. Prophylactic oophorectomy is not a practical
choice for this patient with no family history, even once
she completes childbearing. This option might be
considered for a woman with a strong family history and
the BRCA mutation.
A 25-year-old G0 woman presents for a refill on oral
contraceptives. She has a history of recurrent ovarian
cysts. She has no significant medical or surgical history.
Her grandmother was recently diagnosed with ovarian
cancer and her mother is undergoing treatment for
metastatic breast cancer. The patient is interested in
assessing her risk for ovarian cancer susceptibility.
Which of the following is the most appropriate test to
offer this patient?
A. Annual CA125 levels
B. Annual pelvic ultrasound
C. Genetic testing of BRCA 1 and 2 mutations on the
patient's mother
E. Check the patient for p53 mutation
, 4|Page
D. Genetic testing of BRCA 1 and 2 mutations on the
patient's grandmother - ....ANSWER ....✔✔ Incorrect!
Correct answer is C. BRCA1 and BRCA2 mutations are
typically seen in cases of hereditary ovarian cancers.
Overall, it has been estimated that inherited BRCA1 and
BRCA2 mutations account for 5 to 10 percent of breast
cancers and 10 to 15 percent of ovarian cancers among
white women in the United States. Given this family
history, it is highly likely that a mutation is present, and
the affected individual (proband) should be tested if still
alive. Because breast cancers are part of the BRCA
mutation, the affected mother should be tested. Routine
screening for ovarian cancer has not been established.
A 25-year-old G1P1 woman comes in for her annual
health maintenance examination. She has intermittent
left lower quadrant discomfort. She has regular menses
every 30 days and uses a diaphragm for birth control.
Her last menstrual period was approximately three
weeks ago. Her physical examination is notable for a 3
x 5 cm left adnexal mass. Ultrasound shows a unilocular
simple cyst. Which of the following is the most likely
diagnosis in this patient?
A. Endometrioma
B. Functional ovarian cyst
C. Mucinous cystadenoma
D. Serous cystadenoma
