The impact of prophylactic salpingo-oophorectomy on menopausal symptoms and sexual function in women who carry a BRCA mutation

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

doi:10.1016/j.ygyno.2010.12.326

Cited by 178 publications

(167 citation statements)

References 41 publications

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“…This study suggests that while many women correctly anticipate many of the visible sequelae of risk-reducing surgery, it is also apparent that many remain unprepared for the changes in the way their bodies feel [21,24,26,36] and the ways they may feel about themselves [15,21,25,27,38] following surgery. While health care professionals may do their best to prepare women for physical changes, pain, scarring and reduced libido, there is evidence that the impact upon sexuality, body image and gender identity are not routinely discussed by surgeons and, in line with recommendations made in recent papers [28], we argue that these issues are important topics for discussion in preoperative consultations.…”

Section: Discussionmentioning

confidence: 84%

“…Many of the women who underwent RRM plus reconstruction commented on the numbness, pain and discomfort they experienced as a result of surgery, and described how these sensations negatively affected their everyday activities (sleeping, moving around, sport) as well as their sexuality [36] and body image. While earlier studies suggest that sexual functioning is not compromised by RRM, there is evidence that about half of the women who undergo this procedure report some issues with body image and sexuality [15,19,21], like the women in this study.…”

Section: Discussionmentioning

confidence: 99%

“…The mean age at primary surgery was 43 (range 28-66) years. The mean time since primary RR surgery was 37 (range [34][35][36][37][38][39][40] months. Twenty-five women (63%) carried a BRCA1 or BRCA2 mutation.…”

Section: Data Collection and Analysismentioning

confidence: 99%

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Looking different, feeling different: women’s reactions to risk-reducing breast and ovarian surgery

et al. 2011

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Objectives Most studies of quality of life following risk-reducing bilateral salpingo -oophorectomy (RRSO) and mastectomy (RRM) for inherited breast and ovarian cancer susceptibility were conducted before counseling protocols were established and included women at varying times since surgery. This study aimed to overcome these deficiencies and to provide current data on outcomes for this growing group of women.Methods Semi-structured interviews were used to explore the experiences of an Australian cohort of 40 high-risk women three years after they underwent RRM and/or RRSO. Data were analyzed using the method of constant comparison.Results Nineteen women underwent RRSO, 8 RRM and 13 both procedures. Two themes -looking different and feeling different -captured the psychosocial impact of surgery upon interviewees. All were relieved at having the risk of cancer substantially reduced that had previously been embodied in their breasts and ovaries; however, reducing risk by removing these body parts is not without costs. Interviewees reported experiencing a range of negative emotions and a range of unexpected bodily sensations following surgery and reflected upon both positive and negative changes in their appearance. Women said they had been unprepared for the lack of sensation in reconstructed breasts and/or the severity of menopausal symptoms, which often had a negative impact upon sexuality. ConclusionsAlthough women who undergo RR surgery are informed about its sequelae, however, few are entirely prepared for the reality of undergoing this procedure. We recommend that women who undergo these procedures should be provided with psychosocial support before and after RR surgery.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Looking different, feeling different: women’s reactions to risk-reducing breast and ovarian surgery

et al. 2011

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“…Finch et al [17] recently showed that women who were premenopausal at the time of prophylactic oophorectomy experienced significantly higher rates of hot flashes, night sweats, and sweating than menopausal women. Moreover, they reported that premenopausal women with a previous diagnosis of breast cancer had significantly more vasomotor symptoms before surgery than premenopausal unaffected women [17]. In our study, neither the menopausal status before PBSO nor a previous diagnosis of breast cancer influenced endocrine symptoms (Table 6).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2011

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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-

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“…In addition, few studies have compared women who underwent surgery to controls and these have typically not controlled for potential confounders. In summary, although there is strong evidence that women who undergo RRSO experience an increase in menopausal symptoms [7,23], prospective assessment of the long-term psychosocial and psychosexual impact of RRSO is lacking.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of risk-reducing surgery in unaffected women at increased familial risk of breast and/or ovarian cancer

et al. 2014

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Purpose: To prospectively investigate long-term psychosocial outcomes for women who opted for risk-reducing mastectomy (RRM) and/or risk-reducing salpingo-oophorectomy (RRSO).Methods: Unaffected women from high-risk breast cancer families who had completed baseline questionnaires for an existing study and subsequently underwent RRM and/or RRSO, completed measures of perceived breast and ovarian cancer risk, anxiety, depression, cancer-related anxiety, body image, sexual functioning, menopausal symptoms, use of hormone replacement therapy and decision regret three years post-surgery. Outcomes were compared to age-and risk-matched controls.Results: Participants (N=233) were 17 women who had RRM (39 controls), 38 women who had RRSO (94 controls) and 15 women who had RRM+RRSO (30 controls). Women who underwent RRM and those who underwent RRM+RRSO reported reductions in perceived breast cancer risk and perceived breast and ovarian cancer risk respectively, compared to their respective controls. RRM women reported greater reductions in cancer-related anxiety compared with both controls and RRSO women. RRSO women reported more sexual discomfort than controls and more urogenital menopausal symptoms than controls and RRM only women. No differences in general anxiety, depression or body image were observed. Regret was associated with greater reductions in body image since surgery and more sexual discomfort, although overall regret levels were low. Conclusions:Women who undergo RRM experience psychological benefits associated with reduced breast cancer risk. Although women who undergo RRSO experience some deterioration in sexual and menopausal symptoms, they do not regret their surgery decision. It is vital that women considering these procedures receive detailed information about potential psychosocial consequences.3

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The impact of prophylactic salpingo-oophorectomy on menopausal symptoms and sexual function in women who carry a BRCA mutation

Cited by 178 publications

References 41 publications

Looking different, feeling different: women’s reactions to risk-reducing breast and ovarian surgery

Looking different, feeling different: women’s reactions to risk-reducing breast and ovarian surgery

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

Long-term outcomes of risk-reducing surgery in unaffected women at increased familial risk of breast and/or ovarian cancer

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