Division of Gynecologic Oncology, Women's Health Institute (Dr. AlHilli), Cleveland Clinic, Cleveland, Ohio.
Department of General Surgery, Digestive Diseases and Surgery Institute (Dr. Al-Hilli), Cleveland Clinic, Cleveland, Ohio.
J Minim Invasive Gynecol. 2019 Feb;26(2):253-265. doi: 10.1016/j.jmig.2018.09.767. Epub 2018 Sep 19.
Carriers of genetic mutations that predispose to cancer syndromes are often faced with complex decisions. For women with hereditary breast and ovarian cancer in particular, the decision to undergo risk-reducing mastectomy or bilateral salpingo-oophorectomy is burdensome from a physical and psychological perspective. Although risk-reducing surgery is the most effective preventative measure in reducing a genetic mutation carrier's risk of breast or ovarian cancer, the success of these procedures requires a multidisciplinary approach that centers on careful counseling regarding the risks and benefits of risk-reducing surgery. The physical and psychological distress associated with risk-reducing surgery often makes a combined surgical approach attractive to some patients. In this review, we present the evidence surrounding the comprehensive surgical care of women with hereditary breast and ovarian cancer syndromes and evaluate the perioperative factors that influence surgical management.
携带有致癌症综合征遗传突变的个体常常面临复杂的决策。对于患有遗传性乳腺癌和卵巢癌的女性，特别是在接受预防性降低风险的乳房切除术或双侧输卵管卵巢切除术时，从身体和心理角度来看，这个决定是很沉重的。尽管降低风险的手术是降低基因突变携带者罹患乳腺癌或卵巢癌风险的最有效预防措施，但这些手术的成功需要多学科方法，重点是对降低风险手术的风险和益处进行仔细的咨询。降低风险手术相关的身体和心理困扰往往使一些患者对联合手术方法感兴趣。在这篇综述中，我们介绍了与遗传性乳腺癌和卵巢癌综合征女性综合外科护理相关的证据，并评估了影响手术管理的围手术期因素。
