Factors Associated with Altered Long-Term Well-Being After Prophylactic Salpingo-Oophorectomy Among Women at Increased Hereditary Risk for Breast and Ovarian Cancer

Abstract

After completing this course, the reader will be able to:1. Describe factors associated with decreased well-being after PBSO in order to prospectively identify patients at risk.2. Provide pre-operative counseling and information to patients at risk of decreased well-being after PBSO.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBackground. Prophylactic bilateral salpingo-oophorectomy (PBSO) might alter several components of wellbeing, such as sexual functioning and endocrine symptoms, in women at high risk for hereditary breast and/or ovarian cancer, compared with the general pop-

Psychiatric implications of cancer genetic testing

“…No differences were reported between women with or without a personal history of breast cancer. 111 Women who underwent RRBSO, however, did have more endocrine symptoms and lower sexual functioning, similar to previous studies. Younger age at the time of RRBSO was associated with more endocrine symptoms, lower sexual functioning, greater anxiety, and lower social functioning.…”

“…Younger age at the time of RRBSO was associated with more endocrine symptoms, lower sexual functioning, greater anxiety, and lower social functioning. 111 Hormone-replacement therapy has demonstrated the ability to mitigate the endocrine symptoms and symptoms of lower sexual functioning, but not to presurgical levels. 112,113 These findings, along with reports by 60% of BRCA1/BRCA2 carriers that they would have liked more information about the procedure's impact on their sex lives before their RRSO, 114 highlight the potential benefit of referrals to sexual health clinics before surgery.…”

How medical choices influence quality of life of women carrying a BRCA mutation

“…A c c e p t e d M a n u s c r i p t 17 be temporarily lower at 1 month after surgery compared to women in a surveillance group (Physical Component Summary β -5.61; p<0.02), but this difference was no more apparent after 6 and 12 months [52]. Women who were younger at the time of RRSO, had lower levels of social functioning at follow-up [57]. QoL was significantly correlated with activity in sports, a better physical condition, absence of weight gain and lower levels of depression [56,57].…”

“…Our literature search yielded eight articles concerning the QoL of BRCA mutation carriers after RRSO, of which three were prospective with measurements before and until 12 months after surgery [20,52,53] and five cross-sectional [54][55][56][57][58] of which one also retrospectively evaluated the presurgical status [57], with mean follow-up durations of 6 months to 6 years. A c c e p t e d M a n u s c r i p t 17 be temporarily lower at 1 month after surgery compared to women in a surveillance group (Physical Component Summary β -5.61; p<0.02), but this difference was no more apparent after 6 and 12 months [52].…”

Bilateral Salpingo-Oophorectomy Versus GnRH Analogue in the Adjuvant Treatment of Premenopausal Breast Cancer Patients: Cost-Effectiveness Evaluation of Breast Cancer Outcome, Ovarian Cancer Prevention and Treatment

“…As recognized earlier, [23] the implications of emotional distress from surgically induced menopause are generally hardly quantifiable, and are expected to vary across different clinical settings: for instance, in women at high heredo-familiar risk of developing breast and ovarian cancer, the unfavourable impact of surgically induced menopause on quality of life is overcome by the decrease of anxiety. [19,38,39] On the other hand, the utilities developed in high risk, but still healthy women, unlikely reflect the utilities of patients who have already faced breast carcinoma, as in our model. Therefore, with the aim to provide a really individualized counselling, efforts should be made to develop more specific utilities for each clinical setting.…”