Siyam Tasneem, Ross Sue, Campbell Sandra, Eurich Dean T, Yuksel Nesé
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, T6G 1C9, Canada.
Cavarzan Chair in Mature Women's Health Research, Department of Obstetrics and Gynecology, Rm 5S131 Lois Hole Hospital/Robbins Pavilion Royal Alexandra Hospital, 10240 Kingsway Ave, Edmonton, AB, T5H 3V9, Canada.
BMC Womens Health. 2017 Mar 21;17(1):22. doi: 10.1186/s12905-017-0370-6.
It is unclear if the use of hormone therapy (HT) in carriers of BRCA mutations improves the quality of life (QOL) without increasing the risk of breast cancer following a risk-reducing salpingo-oophorectomy (RRSO). Our objective was to assess the effect of HT on QOL and breast cancer risk, after RRSO.
We searched MEDLINE, EMBASE, CINHAL, and others, from inception to July 22, 2016, to identify relevant studies. Two reviewers independently screened identified records for controlled trials and observational studies that addressed the effect of HT on QOL and breast cancer risk in women with BRCA mutations, post RRSO. Two reviewers independently extracted data on populations, interventions, comparators, outcomes, and methodological quality. Studies addressing the same outcome were synthesized using written evidence summaries or tables.
Of the 1,059 records identified, 13 met our inclusion criteria. All studies were observational. Six studies assessed the effect on QOL. Of these, 3 showed improvement in QOL with HT use. The risk of breast cancer was evaluated in 4 studies. The mean duration of follow-up was 2.6 years (range 0.1-19.1). The risk of breast cancer did not change with HT use in all 4 studies.
Cumulative evidence from our review suggests that short-term HT use following RRSO improves QOL. The effect on breast cancer risk is still unclear. There are too few long-term studies to draw any strong conclusions. The need for future well-designed RCTs for more established evidence is imperative.
对于携带BRCA突变的患者，在进行降低风险的输卵管卵巢切除术（RRSO）后使用激素疗法（HT）是否能在不增加乳腺癌风险的情况下提高生活质量（QOL）尚不清楚。我们的目的是评估RRSO后HT对QOL和乳腺癌风险的影响。
我们检索了MEDLINE、EMBASE、CINHAL等数据库，检索时间从建库至2016年7月22日，以识别相关研究。两名 reviewers 独立筛选已识别的记录，以查找关于HT对RRSO后携带BRCA突变女性的QOL和乳腺癌风险影响的对照试验和观察性研究。两名 reviewers 独立提取关于人群、干预措施、对照、结局和方法学质量的数据。使用书面证据总结或表格对涉及相同结局的研究进行综合分析。
在识别出的1059条记录中，13条符合我们的纳入标准。所有研究均为观察性研究。六项研究评估了对QOL的影响。其中，3项研究表明使用HT可改善QOL。四项研究评估了乳腺癌风险。平均随访时间为2.6年（范围0.1 - 19.1年）。在所有四项研究中，使用HT后乳腺癌风险未发生变化。
我们综述的累积证据表明，RRSO后短期使用HT可改善QOL。对乳腺癌风险的影响仍不清楚。长期研究太少，无法得出任何有力结论。迫切需要未来设计良好的随机对照试验以获得更确凿的证据。
