Skip to main content

Advertisement

Log in

What I wish I’d known before surgery: BRCA carriers’ perspectives after bilateral salipingo-oophorectomy

  • Published:
Familial Cancer Aims and scope Submit manuscript

Abstract

We retrospectively studied BRCA carriers with a history of prophylactic bilateral salingo-oophorectomy (PBSO) regarding: (1) their post-operative symptoms, (2) their recollection of pre-operative conversations with their health care providers regarding possible surgical side-effects and (3) what information they would have found helpful to have before surgery. Female BRCA carriers seen through the Yale Cancer Genetic Counseling Program who had PBSO were invited to participate in a questionnaire that assessed their recall of information they received pre-operatively compared with their post-operative knowledge and symptoms related to menopause, cognitive changes, loss of fertility, cancer risks, osteoporosis, heart disease, vasomotor symptoms, urogenital symptoms, sexuality and body image. The questionnaire also elicited written feedback from participants regarding their decision to have PBSO, what they wished they had known before surgery, advice for other BRCA carriers considering this surgery and advice for health care providers who counsel women about PBSO. Two hundred and ninety female BRCA carriers were invited to participate and 113 (39.0%) indicated they were interested. Of those, 99 (87.6%) returned their questionnaire and 98 (86.7%) responses were included in the analysis. The mean age at PBSO was 45.5 years (range: 32–63 years). The five most common “frequent” or “very frequent” post-surgical symptoms were: vaginal dryness (52.1%), changes in interest in sex (50.0%), sleep disturbances (46.7%), changes in sex life (43.9) and hot flashes (42.9%). The majority of women would have found it helpful to have more information regarding the impact of this surgery on their sex life (59.2%), the availability of sex counseling (57.1%) and the risk of coronary heart disease (57.1%). This study illustrates that while health care providers are discussing selected side effects of PBSO, women undergoing this surgery have other concerns that should be addressed. This information provides insights into the informational needs of BRCA carriers considering PBSO.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kauff ND et al (2002) Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation. N Engl J Med 346(21):1609–1615

    Article  PubMed  Google Scholar 

  2. Stirling D et al (2005) Screening for familial ovarian cancer: failure of current protocols to detect ovarian cancer at an early stage according to the international federation of gynecology and obstetrics system. J Clin Oncol 23(24):5588–5596

    Article  PubMed  Google Scholar 

  3. Rebbeck TR (2000) Prophylactic oophorectomy in BRCA1 and BRCA2 mutation carriers. J Clin Oncol 18(21):100S–103S

    CAS  PubMed  Google Scholar 

  4. Struewing J, Hartge P, Wacholder S (1997) The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. N Engl J Med 336:1401–1408

    Article  CAS  PubMed  Google Scholar 

  5. Ford D, Easton D, Bishop D (1994) Risks of cancer in BRCA1 mutation carriers. Lancet 343:692–695

    Article  CAS  PubMed  Google Scholar 

  6. Antoniou A, Pharoah P, Narod S (2003) Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analyses of 22 studies. Am J Hum Genet 72:1117

    Article  CAS  PubMed  Google Scholar 

  7. NIH Consensus Conference (1995) Ovarian cancer: screening, treatment, and follow-up. NIH consensus development panel on ovarian cancer. JAMA 273:491–497

    Article  Google Scholar 

  8. Domchek S, Friebel T, Neuhausen S et al (2006) Mortality reduction after risk-reducing bilateral salpingo-oophorectomy in a prospective cohort of BRCA1 and BRCA2 mutation carriers. Lancet Oncol 7(3):223–229

    Article  CAS  PubMed  Google Scholar 

  9. Rebbeck TR et al (2002) Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med 346:1616–1622

    Article  PubMed  Google Scholar 

  10. Finch A, Beiner M, Lubinski J et al (2006) Salpingo-oophorectomy and the risk of ovarian, fallopian tube, and peritoneal cancers in women with a BRCA1 or BRCA2 mutation. J Am Med Assoc 296(2):185–192

    Article  CAS  Google Scholar 

  11. NCCN practice guidelines in oncology v.1.2009 (2010): Hereditary breast and ovarian cancer. Available via: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp Cited July 26, 2010

  12. American College of Obstetricians and Gynecologists; ACOG Committee on Practice Bulletins—Gynecology; ACOG Committee on Genetics; Society of Gynecologic Oncologists (2009) ACOG practice bulletin no. 103: hereditary breast and ovarian cancer syndrome. Obstet Gynecol 113(4):957–966

    Google Scholar 

  13. Bradbury AR et al (2008) Uptake and timing of prophylactic salpingo-oophorectomy among BRCA mutation carriers. Genet Med 10(3):161–166

    Article  PubMed  Google Scholar 

  14. Meijers-Heijboer EJ et al (2000) Presymptomatic DNA testing and prophylactic surgery in families with a BRCA1 or BRCA2 mutation. Lancet 355:2015–2020

    Article  CAS  PubMed  Google Scholar 

  15. Bachmann GA (1999) Vasomotor flushes in menopausal women. Am J Obstet Gynecol 180:S312–S316

    Article  CAS  PubMed  Google Scholar 

  16. Taylor M (2001) Psychological consequences of surgical menopause. J Reprod Med 46:317–324

    CAS  PubMed  Google Scholar 

  17. Madalinska JB et al (2005) Quality-of-life effects of prophylactic salpingo-oophorectomy versus gynecologic screening among women at increased risk of hereditary ovarian cancer. J Clin Oncol 23:6890–6898

    Article  PubMed  Google Scholar 

  18. Stephenson J (2003) FDA orders estrogen safety warnings: agency offers guidance for HRT use. JAMA 289:537–538

    Article  PubMed  Google Scholar 

  19. Madalinska JB et al (2006) The impact of hormone replacement therapy on menopausal symptoms in younger high-risk women after prophylactic salpingo-oophorectomy. J Clin Oncol 24(22):3576–3582

    Article  PubMed  Google Scholar 

  20. Horner MJ, Ries LAG, Krapcho M, Neyman N, Aminou R, Howlader N, Altekruse SF, Feuer EJ, Huang L, Mariotto A, Miller BA, Lewis DR, Eisner MP, Stinchcomb DG, Edwards BK (eds) (1975–2006) SEER cancer statistics review. National Cancer Institute, Bethesda, MD. http://seer.cancer.gov/csr/1975–2006/, based on November 2008 SEER data submission, posted to the SEER web site, 2009

  21. Elit L et al (2001) Quality of life and psychosexual adjustment after prophylactic oophorectomy for a family history of ovarian cancer. Fam Cancer 1:149–156

    Article  CAS  PubMed  Google Scholar 

  22. Hallowell N (2000) A qualitative study of the information needs of high-risk women undergoing prophylactic oophorectomy. Psychooncology 9:486–495

    Article  CAS  PubMed  Google Scholar 

  23. Swisher EM et al (2001) Prophylacic oophorectomy and ovarian cancer surveillance: patient perceptions and satisfaction. J Reprod Med 46:87–94

    CAS  PubMed  Google Scholar 

  24. Fry A et al (2001) Deciding about prophylactic oophorectomy: what is important to women at increased risk of ovarian cancer? Prev Med 33:578–585

    Article  CAS  PubMed  Google Scholar 

  25. Miller SM et al (1999) Decision making about prophylactic oophorectomy among at-risk women: psychological influences and implications. Gynecol Oncol 75:406–412

    Article  CAS  PubMed  Google Scholar 

  26. Marwick C (1999) Survey says patients expect little physician help on sex. JAMA 281(23):2173–2174

    Article  CAS  PubMed  Google Scholar 

  27. Matloff ET, Barnett RE, Bober SL (2009) Unraveling the next chapter: sexual development, body image, and sexual functioning in female BRCA carriers. Cancer J 15(1):15–18

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Danielle Campfield Bonadies.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Campfield Bonadies, D., Moyer, A. & Matloff, E.T. What I wish I’d known before surgery: BRCA carriers’ perspectives after bilateral salipingo-oophorectomy. Familial Cancer 10, 79–85 (2011). https://doi.org/10.1007/s10689-010-9384-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10689-010-9384-z

Keywords

Navigation