The impact of prophylactic salpingo‐oophorectomy on quality of life and psychological distress in women with a BRCA mutation

Finch, Amy; Metcalfe, Kelly; Chiang, Jaclyn; Elit, L.; McLaughlin, John; Springate, C.; Esplen, Mary Jane; Demsky, Rochelle; Murphy, Joan; Rosen, Barry P.; Narod, Steven A.

doi:10.1002/pon.2041

Cited by 76 publications

(76 citation statements)

References 30 publications

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“…In addition, the total IES-R scores were significantly lower at 1 year after surgery. This result indicated that RRSO reduced the psychological impact and burden of knowing the results of genetic testing in addition to reducing anxiety over the development of cancer (cancer-specific distress), consistent with the results of previous studies conducted overseas (15). These results suggest that RRSO effectively reduces anxiety over the future development of breast and ovarian cancer associated with BRCA1/2 mutation and its associated psychological burden.…”

Section: (250)supporting

confidence: 89%

“…In addition, studies suggested that while reducing concerns regarding the potential development of breast or ovarian cancer, RRSO also does not adversely influence the quality of life (QOL) (14). Furthermore, it has also been shown that RRSO does not worsen the physical or psychological aspects of QOL, but reduces distress related to the risk of the development of ovarian cancer (15). In Japan, it is also considered important for patients undergoing RRSO to receive appropriate support and to minimize psychosocial damage.…”

Section: Introductionmentioning

confidence: 99%

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Study on the psychosocial aspects of risk-reducing salpingo-oophorectomy (RRSO) in BRCA1/2 mutation carriers in Japan: a preliminary report

Shigehiro

Kita

Takeuchi

et al. 2015

Jpn. J. Clin. Oncol.

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Objective: This study investigated the psychosocial aspects of risk-reducing salpingo-oophorectomy in Japan. Methods: The subjects were 16 patients who underwent risk-reducing salpingo-oophorectomy at the Cancer Institute Hospital. Worry about cancer, emotional state and cancer-specific distress level were evaluated using a four-point Likert scale, the Profile of Mood States-Short Form and the Impact of Event Scale-Revised, respectively, before and 1 year after the surgery. In addition, the subjects were interviewed regarding their expectation for the risk-reducing surgery, the effects of the surgery, and the recovery from surgery, before the surgery and at 1, 6 and 12 months after the surgery. A t-test or Wilcoxon rank-sum test was used for the analysis, and literal analects were prepared for the interview and the answers were organized per question item using NVIVO10. Results: The results revealed that the total score for worry about breast cancer and ovarian cancer (P = 0.021) as well as the Impact of Event Scale-Revised (P = 0.021) were significantly lower 1 year after surgery, compared with the values before the surgery. Regarding the preoperative expectations for the surgery, the expectation for reducing the cancer risk was the highest. The reported effects of risk-reducing salpingo-oophorectomy on life included the appearance of menopausal symptoms, a loss of motivation and poor concentration; more effects were reported at 1 year after surgery than at 6 months after surgery. Conclusions: These results suggest that risk-reducing salpingo-oophorectomy can be effective for reducing worry about breast cancer and ovarian cancer and cancer-specific distress as well as contributing to a reduction in mortality from fallopian tube and ovarian related cancer.

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Section: (250)supporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Study on the psychosocial aspects of risk-reducing salpingo-oophorectomy (RRSO) in BRCA1/2 mutation carriers in Japan: a preliminary report

Shigehiro

Kita

Takeuchi

et al. 2015

Jpn. J. Clin. Oncol.

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“…General distress was comparable in women after RRSO compared to age-matched controls infrom the general population (Brief Symptom Inventory Global score 50.1 versus 50) [53]. Cancer-specific distress significantly decreased (IES from 19.2 (range 0-57) to 10.4 (range 0-53)) after RRSO but was still moderately or severely present in a moderate or severe amount in 19% of participants [53].…”

Section: Psychological Distress: Anxiety Depression and Cancer Worrymentioning

confidence: 82%

“…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].…”

Section: Ovarian Cancer In Germline Brca Gene Mutation Carriersmentioning

confidence: 99%

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

Harmsen

Hermens

Prins³

et al. 2015

Critical Reviews in Oncology/Hematology

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“…107 Studies also have demonstrated lower levels of depression and anxiety. [107][108][109] After risk RRM, women report a positive emotional response related to the reduction of their breast cancer risk. 110 However, cancer worries did not appear to decrease in another study of younger female gene carriers who underwent prophylactic mastectomy and oophorectomy.…”

Section: Hbocmentioning

confidence: 99%

Psychiatric implications of cancer genetic testing

Hirschberg

Chan‐Smutko

Pirl

2014

Cancer

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As genetic testing for hereditary cancer syndromes has transitioned from research to clinical settings, research regarding its accompanying psychosocial effects has grown. Men and women being tested for hereditary cancer syndromes may experience some psychological distress while going through the process of testing or after carrier status is identified. Psychological distress appears to decrease over the course of the first year and it is typically not clinically significant. Longer term studies show mixed results with some mutation carriers continuing to experience elevated distress. Baseline distress is the greatest risk factor for both immediate (weeks-12 months) and long-term psychological distress (18 mo-8 years post genetic testing). In addition to baseline psychological distress, other risk factors can be identified to help identify individuals who may need psychosocial interventions during the genetic testing process. The challenges of providing clinical care to the growing population of individuals identified to be at increased risk for heritable cancers present opportunities for research and new models of care. Cancer 2015;121:341-60. V C 2014 American Cancer Society.KEYWORDS: BRCA1, BRCA2, HNPCC, Lynch syndrome, genetic testing, unaffected carrier, carrier, hereditary cancer syndrome, riskreducing surgeries, psychosocial. INTRODUCTIONSeveral familial cancer syndromes that confer a high lifetime risk of cancer can be identified with genetic testing, and greater numbers of men and women will consider testing as the availability and public awareness of genetic testing for cancer susceptibility continue to increase. Research to date suggests that these individuals will have varied emotional responses to the process of genetic testing as well as its results.When genetic testing for cancer syndromes first transitioned from research protocols to clinics, there was initial concern that it would be similar to genetic testing for Huntington disease. Many worried that knowing they are at high risk for cancer in the future may be too distressing for some individuals, possibly even leading to suicide. However, several systematic reviews focusing primarily on hereditary breast and ovarian cancer (HBOC) and Lynch syndrome, also known as hereditary nonpolyposis colon cancer (HNPCC), have demonstrated that most individuals who have a mutation identified in an associated gene cope well with the knowledge of their genetic status. 1-3 Data regarding psychological implications of the genetic testing process are the most robust for women who present for HBOC risk assessment, which involves discussion of the BRCA1 and BRCA2 genes, although there are increasing studies for HNPCC, familial adenomatous polyposis (FAP), and other hereditary cancer syndromes.Although the rates of distress in individuals undergoing genetic testing vary, they appear to be relatively small. Studies have demonstrated that approximately 6% to 24% of individuals undergoing genetic testing for a BRCA1/BRCA2-associated or HNPCC-associated mutations repo...

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The impact of prophylactic salpingo‐oophorectomy on quality of life and psychological distress in women with a BRCA mutation

Cited by 76 publications

References 30 publications

Study on the psychosocial aspects of risk-reducing salpingo-oophorectomy (RRSO) in BRCA1/2 mutation carriers in Japan: a preliminary report

Study on the psychosocial aspects of risk-reducing salpingo-oophorectomy (RRSO) in BRCA1/2 mutation carriers in Japan: a preliminary report

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

Psychiatric implications of cancer genetic testing

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