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I think a genetic counseling consultation would be reasonable. Guidelines vary whether germline testing and genetic counseling are indicated for RCC diagnoses under age 40, or under age 50, meaning she would meet some criteria based on age alone. Given the clear cell diagnosis, ensuring SDH deficiency was ruled out can also be helpful. However, ultimately if she has concerns for her children, even if she doesn't meet insurance criteria, genetic testing is very affordable out of pocket (typically through insurance patients pay $50 or less, or $250 self pay). Referring to genetics allows the genetic counselors to help facilitate that conversation.
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