Satisfaction and overall quality of life in BRCA positive women after prophylactic surgeries
Authors:
P. Šašková; D. Pavlišta
; L. Dostálek
Authors place of work:
Gynekologicko-porodnická klinika 1. LF Univerzity Karlovy a VFN Praha
přednosta: prof. MUDr. A. Martan, DrSc.
Published in the journal:
Rozhl. Chir., 2017, roč. 96, č. 8, s. 328-333.
Category:
Review
Summary
Introduction:
Genetic mutations are responsible for 5–10% of all breast and ovarian carcinomas, while most of them are caused by a mutation of the BRCA gene. Women with this type of mutation have a lifetime risk of breast and ovarian cancer and therefore, they require very intensive medical care, including surgical prevention. Specifically, prophylactic bilateral mastectomy and prophylactic salpingo-oophorectomy are done, which undoubtedly decrease the riskof cancer. The aim of this review article is to inform healthcare professionals and the general public about the satisfaction of BRCA positive women with their decision to undergo these prophylactic surgeries, and also about the impact of these procedures on sexuality, menopausal symptoms, mental health and the overall quality of life.
Methods:
Search of original studies and review articles onthe influence of prophylactic surgeries on the life of women with BRCA genemutation.
Results:
In general, although some changes are observed after the prophylactic surgeries, the overall quality of life does not change. A significant reduction in anxiety and fear of cancer is observed after both prophylactic bilateral mastectomy andprophylactic bilateral salpingo-oophorectomy, providing great psychological relief to the affected women. However, prophylactic bilateral salpingo-oophorectomy causes premature menopause in premenopausal women at the time of surgery and the associated occurrence of menopausal symptoms. Some of the symptoms can be significantly reduced by hormone replacement therapy but will not be eliminated altogether. In postmenopausal women, no or minimal worsening of menopausal symptoms was reported. After prophylactic bilateral mastectomy, particularly appearance-related problems were observed. In both types of surgery, sexual problems were also observed.
Conclusion:
The relief of reducingthe risk of cancerappears to be so great and so important for women that it outweighs the other negative effects of these prophylactic procedures.
Key words:
BRCA1/2 mutation – breast cancer – ovarian cancer – prophylactic bilateral salpingo-oophorectomy – prophylactic bilateral mastectomy
Zdroje
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