UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA 94143, USA.
Gynecol Oncol. 2011 Aug;122(2):339-43. doi: 10.1016/j.ygyno.2011.04.004. Epub 2011 Apr 30.
To characterize the post-operative care of BRCA1 and BRCA2 mutation carriers who undergo risk-reducing salpingo-oophorectomy (RRSO).
BRCA1 and BRCA2 mutation carriers from our Cancer Risk Program who elected RRSO were sent questionnaires regarding their post-surgical surveillance and treatment for menopause symptoms, primary peritoneal cancer and bone loss.
In 51 mutation carriers who were surveyed a median of 6 years after RRSO, 24 (47%) received dual-energy X-ray absorptiometry (DXA) testing, yearly CA-125 serum testing and yearly pelvic examination. Three women received none of these examinations in follow-up. Respondents reported an average of 3.5 menopausal symptoms (range 0-9). The mean number of menopausal symptoms reported by respondents using HRT was 2.8, compared to 3.9 symptoms reported by women not using HRT (p=0.06). Six of 10 (60%) subjects who reported no history of DXA bone scan, and 10 of 15 (67%) subjects who reported no post-surgical CA-125 serum monitoring noted that their physicians "did not recommend" testing. Two out of six symptomatic women who were younger than 50 (33%) who had no other contraindication to the use of HRT reported their non-use was because their care providers "advised against" HRT use.
We believe that the lack of post-RRSO health care guidelines has resulted in inconsistent care for this cohort of patients. We proposed that national guidelines be developed to standardize care with the goal of optimizing long term survival in this unique cohort of young cancer previvors.
描述接受预防性输卵管卵巢切除术（RRSO）的 BRCA1 和 BRCA2 突变携带者的术后护理情况。
从我们的癌症风险计划中选择 RRSO 的 BRCA1 和 BRCA2 突变携带者被发送了关于他们手术后的监测以及治疗更年期症状、原发性腹膜癌和骨质疏松症的问卷。
在接受 RRSO 后中位数为 6 年的 51 名突变携带者中，24 名（47%）接受了双能 X 线吸收测定法（DXA）检测、每年 CA-125 血清检测和每年盆腔检查。有 3 名女性在随访中没有接受任何这些检查。受访者报告平均有 3.5 种更年期症状（0-9 种）。使用 HRT 的受访者报告的平均更年期症状数为 2.8，而未使用 HRT 的女性报告的症状数为 3.9（p=0.06）。报告没有 DXA 骨扫描病史的 10 名受试者中有 6 名（60%），报告没有 RRSO 后 CA-125 血清监测的 15 名受试者中有 10 名（67%）表示他们的医生“不建议”进行检测。在没有其他使用 HRT 禁忌症的 6 名有症状的年轻于 50 岁的女性中（33%），有 2 名女性表示她们没有使用 HRT，是因为她们的医护人员“建议不要使用”。
我们认为缺乏 RRSO 后保健指南导致了这组患者的护理不一致。我们建议制定国家指南，以标准化护理，目标是优化这一独特的年轻癌症前生存者队列的长期生存。
