Obstetrics and Gynaecology Unit, Umberto I Hospital, University of Turin, Italy.
Gynaecology and Obstetrics I, Department of Surgical Sciences, Sant'Anna Hospital, University of Turin, Italy.
Clin Breast Cancer. 2018 Dec;18(6):e1361-e1366. doi: 10.1016/j.clbc.2018.07.015. Epub 2018 Jul 26.
BRCA 1 and 2 mutation carriers are invited to follow intensive clinical and instrumental surveillance programs or are offered prophylactic breast and ovarian surgery. These recommendations impact many aspects of their life. This study aims to evaluate the satisfaction with surveillance and prophylactic surgery and the impact of these procedures on the quality of life.
An anonymous questionnaire was administered to 174 BRCA1-2 mutation carriers.
A total of 95% of women comply with the scheduled checks every 6 months. Periodic examinations are considered useful for early diagnosis of breast/ovarian cancer by 91.5% of responders. Among those women who received prophylactic breast surgery, 95% believe that this procedure can reduce cancer risk, but only 65% were completely satisfied by the cosmetic outcome. Among women who underwent prophylactic ovarian surgery, 90.5% would choose it again, mainly owing to a lower degree of concern about ovarian cancer risk. The early onset of menopausal symptoms was the most frequently reported side effects, but only 21% of patients use any treatment to relieve them.
Women who follow a surveillance program show a good level of satisfaction, thanks to the lowering of concerns of cancer risk. The degree of satisfaction about the prophylactic surgery is generally high. Risk-reducing mastectomy is usually well-accepted, despite the fact that cosmetic results are not entirely satisfactory. Bilateral salpingo-oophorectomy may impact on quality of life because of the symptoms associated with early surgical menopause, even if it can be treated with hormonal replacement therapies.
BRCA1 和 BRCA2 基因突变携带者被邀请参加强化临床和仪器监测计划，或接受预防性乳房和卵巢手术。这些建议会影响他们生活的许多方面。本研究旨在评估对监测和预防性手术的满意度，以及这些手术对生活质量的影响。
对 174 名 BRCA1-2 基因突变携带者进行了匿名问卷调查。
共有 95%的女性每 6 个月按时进行计划检查。91.5%的应答者认为定期检查有助于早期诊断乳腺癌/卵巢癌。在接受预防性乳房手术的女性中，95%的人认为该手术可以降低患癌风险，但只有 65%的人对美容效果完全满意。在接受预防性卵巢手术的女性中，90.5%的人会再次选择这种手术，主要是因为对卵巢癌风险的担忧程度降低。绝经症状提前是最常报告的副作用，但只有 21%的患者使用任何治疗方法来缓解这些症状。
参加监测计划的女性满意度较高，这要归功于降低了对癌症风险的担忧。预防性手术的满意度普遍较高。尽管美容效果并不完全令人满意，但降低风险的乳房切除术通常被广泛接受。双侧输卵管卵巢切除术可能会因与早期手术性绝经相关的症状而影响生活质量，尽管可以用激素替代疗法治疗。
