Hormone therapy after risk-reducing surgery in patients with BRCA1/BRCA2 mutation: evaluation of potential benefits and safety

Filho, Agnaldo Lopes da Silva; Carvalho, Gabriella Martins; Sena, Larissa Cristelli de; Gomes, Lívia Passini Guimarães; Valério, Marcos Flávio Habib; Martins, Raíssa Isabelle Leão; Cândido, Eduardo Batista

doi:10.1590/1806-9282.66.8.1134

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…Hormone replacement therapy (HRT) is the only effective strategy to compensate for the lack of hormones induced surgically. The addition of estrogen alone does not increase the risk of breast cancer in these women but the addition of progesterone, which is needed to protect the endometrium, is not adequately studied to confirm its safety ([ 30 , [44] , [45] , [46] ]). The risk associated with progestins/progesterone may be of little clinical impact in women undergoing both PBSO and RRM [ 30 ].…”

Section: Prophylactic Bilateral Salpingo-oophorectomy (Pbso)mentioning

confidence: 99%

Management of patients with BRCA mutation from the point of view of a breast surgeon

Riis

2021

Annals of Medicine &Amp; Surgery

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Germ-line mutation in BRCA (BReast CAncer gene) 1 or BRCA2 are found in 3–4% of all women with breast cancer. These patients have a significant increased risk of breast and ovarian cancer. They are often younger when diagnosed with the mutation, and the possible breast cancer they get is often aggressive with inferior outcome. There are risk reducing strategies, and the most powerful strategy is risk reducing surgery, both risk reducing bilateral mastectomy (RRM) and risk reducing bilateral salpino-oophorectomy (PBSO). This review is meant to address breast surgery in patients with germline BRCA mutation. The guidelines and techniques applied is under continuous change and it is important for the clinicians to be well informed to provide the patient with the information needed for them to make an informed decision on what risk strategy to choose.

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Section: Prophylactic Bilateral Salpingo-oophorectomy (Pbso)mentioning

confidence: 99%

Management of patients with BRCA mutation from the point of view of a breast surgeon

Riis

2021

Annals of Medicine &Amp; Surgery

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“…Hormone replacement with estrogen, when properly performed after RRBSO, helps control postmenopausal symptoms and prevents chronic diseases associated with reduced estrogen levels, such as osteoporosis and myocardial infarction (Huber et al, 2021). In addition, improvements are observed in the quality of life of women who undergo hormone replacement therapy after prophylactic salpingo-oophorectomy, such as a reduction in vasomotor symptoms, improvement in sexual function and a decrease in the likelihood of bone diseases (SILVA et al, 2020).…”

Section: Hormone Therapies In Preventionmentioning

confidence: 99%

Effectiveness of New Surgical Techniques, Hormonal Therapies and Immunotherapies in Reducing the Risk of Ovarian Cancer

Moraes,

Rocha,

Ribeiro

et al. 2023

JHSR

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OBJECTIVE: To evaluate the effectiveness of new surgical techniques, hormonal therapies and immunotherapies in reducing the risk of ovarian cancer. METHODOLOGY: This is a bibliographic review developed according to the criteria of the PVO strategy. The searches were carried out in the PubMed and SciELO databases. After associating the descriptors used in the researched databases, 14 studies were selected to compose the collection. DISCUSSION: Ovarian cancer is the fifth leading cause of cancer death in women. Patients considered at risk include those who have first-degree relatives affected by ovarian cancer, obesity, smoking, and mutations in the BRCA1 and BRCA2 genes. Prophylactic oophorectomy is a minimally invasive surgical procedure that involves laparoscopic removal of the adnexa and endometrial biopsy. High-grade serous ovarian cancer has a poor prognosis due to the limited effectiveness of currently available chemotherapies. Hormone replacement with estrogen, when properly performed after riskreducing salpingo-oophorectomy (RRBSO), helps control postmenopausal symptoms. Chemotherapy can induce amenorrhea in 60% to 80% of premenopausal women who receive adjuvant treatment. CONCLUSION: Ovarian cancer requires an approach that provides more information to the population. Chemoprevention, whether natural or synthetic, is an effective alternative, unlike immunotherapy, which has limited and more specific efficacy.

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“…2 La menopausia temprana y la caída abrupta de los estrógenos posquirúrgica causan una disminución en la calidad de vida debido a los síntomas de la menopausia y también pueden aumentar el riesgo de enfermedad cardiovascular, osteoporosis y alteración cognitiva. Los síntomas climatéricos, en estos casos, suelen ser más intensos con respecto a la menopausia natural 3 . Hay cierta evidencia de que la SOB en la población general se asocia con un aumento de la mortalidad, especialmente cuando se realiza en edades tempranas si no se prescribe terapia hormonal de la menopausia (THM).…”

Section: Introductionunclassified

Menopausia quirúrgica en pacientes con mutación BRCA, el rol de la terapia hormonal

Galarza Taborda,

Belardo

2023

Rev. Hosp. Ital. B.Aires

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Introducción: las mujeres con mutación BRCA1/2 (mBRCA) tienen un riesgo aumentado de desarrollar cáncer de mama (CM) y ovario (CO). La salpingo-ooforectomía bilateral (SOB) se asocia con la reducción del riesgo del 80% para CO y un 50% para CM. Se recomienda realizarla entre los 35 y 40 años. Como consecuencia se produce una menopausia prematura, con un impacto negativo sobre la calidad de vida por la presencia de síntomas climatéricos, aumento del riesgo de enfermedad cardiovascular, osteoporosis y riesgo de alteración cognitiva. La terapia hormonal (THM) es el tratamiento más efectivo para la prevención de estos síntomas. Estado del arte: distintos estudios han demostrado un mayor riesgo de CM en mujeres posmenopáusicas que reciben THM en particular con terapia combinada, estrógeno + progesterona (E+P). Según el metanálisis de Marchetti et al, en las mujeres portadoras de mBRCA que recibieron THM, no hubo diferencias en el riesgo de CM comparando E solo con E+P. En el estudio de Kostopoulos, inclusive, se encontró un posible efecto protector en aquellas que usaron E solo. Otro estudio en portadoras sanas, demostró que en las mujeres menores de 45 años al momento de la SOB, la THM no afectó las tasas de CM. Sin embargo, en las mujeres mayores de 45 años, las tasas de CM fueron más altas. Como el esquema de E+P se asocia con un mayor RR de CM, las dosis de progestágenos utilizados se deberían limitar, eligiendo derivados naturales de progesterona, de uso intermitente para disminuir la exposición sistémica. Según diferentes guías internacionales, los portadores de mBRCA sanas que se someten a una SOB se les debe ofrecer THM hasta la edad promedio de la menopausia. Conclusión: la menopausia prematura disminuye la expectativa de vida, es por ello que una de las herramientas para mejorar y prevenir el deterioro de la calidad de vida es la THM. El uso de THM a corto plazo, parece seguro para las mujeres portadoras de mBRCA que se someten a una SOB antes de los 45 años, al no contrarrestar la reducción del riesgo de CM obtenida gracias a la cirugía.

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Hormone therapy after risk-reducing surgery in patients with BRCA1/BRCA2 mutation: evaluation of potential benefits and safety

Cited by 4 publications

References 21 publications

Management of patients with BRCA mutation from the point of view of a breast surgeon

Management of patients with BRCA mutation from the point of view of a breast surgeon

Effectiveness of New Surgical Techniques, Hormonal Therapies and Immunotherapies in Reducing the Risk of Ovarian Cancer

Menopausia quirúrgica en pacientes con mutación BRCA, el rol de la terapia hormonal

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