Vos EL, Salo-Mullen EE, Tang LH, et al. - Via a cohort study of 181 patients with CDH1 germline variants from a single institution (mean [SD] age at time of testing, 44 [15] years; 126 [70%] female), researchers sought to determine the correlation between CDH1 variant pathogenicity or family history of gastric or lobular breast cancer and identification of signet ring cell cancer. In addition, they sought to characterize how risk-reducing minimally invasive and open total gastrectomy impacts outcomes. Among the individuals who underwent total gastrectomy, the surgical specimens of 89% of patients with a family history of gastric cancer and 67% of patients lacking family history exhibited signet ring cell cancer. Outcomes suggest a possible necessity for performing total gastrectomy among patients with CDH1 variants and a family history of gastric cancer and indicate it as possibly appropriate for those without a family history.