Use of total abdominal hysterectomy and hormone replacement therapy in BRCA1 and BRCA2 mutation carriers undergoing risk-reducing salpingo-oophorectomy

Gabriel, Courtney; Tigges-Cardwell, Jessica; Stopfer, Jill E.; Erlichman, Julie; Nathanson, Katherine L.; Domchek, Susan M.

doi:10.1007/s10689-008-9208-6

Cited by 40 publications

(37 citation statements)

References 23 publications

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“…In this group, the use of HT decreased after 2002 from 53% to 36%, and fewer women with an intact uterus took HT after 2002 (25% vs. 63%). 106 There was no increase in hysterectomy rates in this study after 2002, suggesting that BRCA mutation carriers' interest in using any type of HT decreased after 2002.…”

Section: Is Ht Safe In Brca Mutation Carriers After Rrso?mentioning

confidence: 66%

Challenging and Complex Decisions in the Management of the BRCA Mutation Carrier

Stan

Shuster

Wick

et al. 2013

Journal of Women's Health

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Women afflicted by the hereditary breast and ovarian cancer syndrome face complex decisions regarding medical interventions aimed at reducing their risk of ovarian and breast cancer, interventions which in turn may interfere with their fertility and cause early menopause. This review addresses selected topics of importance and controversy in the management of the BRCA mutation carrier, such as psychological well-being and quality of life, breast and ovarian cancer screening, risk-reducing interventions for breast cancer and ovarian cancer, the issue of hysterectomy at the time of the risk-reducing salpingo-oophorectomy, health consequences of early surgical menopause, and safety of hormonal therapy after oophorectomy. The information presented is based on an extensive review of the literature on the selected topics and on the expertise of our multidisciplinary team.

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Section: Is Ht Safe In Brca Mutation Carriers After Rrso?mentioning

confidence: 66%

Challenging and Complex Decisions in the Management of the BRCA Mutation Carrier

Stan

Shuster

Wick

et al. 2013

Journal of Women's Health

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“…It seems that previous reports overestimated the incidence of primary peritoneal carcinoma following preventative oophorectomy, possibly due to missed diagnosis of early or occult cancer at the time of surgery [48]. This surgery can be followed by hormone replacement in HBOC patients without apparent detrimental effect [80].…”

Section: Surgical Preventionmentioning

confidence: 98%

“…Gonadectomy for ovarian cancer prevention in HBOC patients can be performed any time before the diagnosis of ovarian cancer has been made, but is best planned for around the age of 40 years [80]. Earlier oophorectomy is advised for breast cancer risk reduction and should be considered around the age of 35 years [81].…”

Section: Surgical Preventionmentioning

confidence: 99%

Screening for gynaecologic cancers in genetically predisposed women

Dreyer

2012

Best Practice & Research Clinical Obstetrics & Gynaecol

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Hereditary breast and ovarian cancer (HBOC) syndrome and hereditary nonpolyposis colon cancer (HNPCC) syndrome are the two most important syndromes responsible for inherited cancers in gynaecology. Genetic testing is available for both these syndromes. BRCA testing is affordable and easy in patients with ancestry where the mutation patterns are known, other population groups need full gene screening. HNPCC can now be diagnosed more frequently with the use of immunohistochemistry.Ovarian cancer risk is high in HBOC syndromes and advanced screening techniques should be used when preventive surgery is not an option. Early detection techniques offer less protection than prophylactic removal, but enable the patient to retain her reproductive organs. Oophorectomy has the advantage of reducing breast cancer risk.In colorectal cancer syndromes the risk for endometrial and ovarian cancer is much elevated. These risks should be recognised and addressed as these diseases are easy to prevent.

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“…For BRCA-positive women who have undergone risk-reducing bilateral salpingoophorectomy, observational data 15 suggest that systemic hormone therapy to the median age of menopause to decrease health risks associated with premature loss of estrogen does not increase breast cancer risk, with decisions considered on an individual basis.…”

Section: Family History Of Breast Cancermentioning

confidence: 99%

Changing the conversation about hormone therapy

Pinkerton

2017

Climacteric

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Use of total abdominal hysterectomy and hormone replacement therapy in BRCA1 and BRCA2 mutation carriers undergoing risk-reducing salpingo-oophorectomy

Abstract: In this single institution study, the majority of BRCA1/2 mutation carriers undergoing RRSO also underwent TAH, and a substantial number took HRT. TAH did not increase the likelihood of taking HRT compared to RRSO alone.

Cited by 40 publications

References 23 publications

Challenging and Complex Decisions in the Management of the BRCA Mutation Carrier

Challenging and Complex Decisions in the Management of the BRCA Mutation Carrier

Screening for gynaecologic cancers in genetically predisposed women

Changing the conversation about hormone therapy

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