Hereditary diffuse gastric cancer: One family’s story

Table 1 CDH1 related cancer risks and International Gastric Cancer Linkage Consortium 8th workshop management recommendations

	Gastric cancer	Lobular breast cancer	Colon cancer
Lifetime cancer risk	80%	60%	Unknown
Surveillance	EGD surveillance in persons not willing to undergo prophylactic gastrectomy	Annual clinical breast exams	Colon cancer screening in HDGC families with colon cancer from age 40 or 10 yr younger than the youngest diagnosis of colon cancer
	If CDH1 + with no evidence of cancer, EGD surveillance, usually starting at age 16 until time of prophylactic gastrectomy per IGCLC 7 guideline[11]	Bilateral breast MRI starting at age 30	Repeat colonoscopy at 3-5 yr intervals per IGCLC 7 guidelines[11]
Therapy	Suggest prophylactic gastrectomy between age 20-30 if CDH1 + without evidence of cancer Suggests gastrectomy if evidence of cancer regardless of age	Prophylactic mastectomy not recommended, but may be considered on case by case basis	Not available

EGD: Esophagogastroduodenoscopies; HDGC: Hereditary diffuse gastric cancer; IGCLC: International Gastric Cancer Linkage Consortium.