Factors Associated with Altered Long‐Term Well‐Being After Prophylactic Salpingo‐Oophorectomy Among Women at Increased Hereditary Risk for Breast and Ovarian Cancer

Learning Objectives After completing this course, the reader will be able to: Describe factors associated with decreased well‐being after PBSO in order to prospectively identify patients at risk. Provide pre‐operative counseling and information to patients at risk of decreased well‐being after PBSO....

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Published in:The oncologist (Dayton, Ohio) Ohio), 2011-09, Vol.16 (9), p.1250-1257
Main Authors: Touboul, Cyril, Uzan, Catherine, Ichanté, Jean Laurent, Caron, Olivier, Dunant, Ariane, Dauchy, Sarah, Gouy, Sébastien, Paillerets, Brigitte Bressac, Morice, Philippe, Delaloge, Suzette
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Anxiety
BRCA
Breast Neoplasms - genetics
Breast Neoplasms - prevention & control
Fallopian Tubes - surgery
Female
Genetic Predisposition to Disease
Gynecologic Oncology
Hereditary breast and ovarian cancer
Humans
Inventories
Menopause
Middle Aged
Multivariate Analysis
Ovarian cancer
Ovarian Neoplasms - genetics
Ovarian Neoplasms - prevention & control
Ovariectomy - methods
Prophylactic oophorectomy
Quality of Life
Risk Assessment
Risk Factors
Risk groups
Sexual function
Sports
Standard deviation
Surgery
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Summary:Learning Objectives After completing this course, the reader will be able to: Describe factors associated with decreased well‐being after PBSO in order to prospectively identify patients at risk. Provide pre‐operative counseling and information to patients at risk of decreased well‐being after PBSO. This article is available for continuing medical education credit at CME.TheOncologist.com Background. Prophylactic bilateral salpingo‐oophorectomy (PBSO) might alter several components of well‐being, such as sexual functioning and endocrine symptoms, in women at high risk for hereditary breast and/or ovarian cancer, compared with the general population. We searched for factors associated with altered long‐term well‐being in this population (lower quality of life [QOL], altered sexual functioning, greater anxiety, more endocrine symptoms). Methods. All high‐risk women who had undergone PBSO during the past 15 years in a single cancer center were contacted by mail. Upon acceptance, they were sent five questionnaires: (a) general social questions, (b) the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, (c) Sexual Activity Questionnaire, (d) Functional Assessment of Cancer Therapy – Endocrine Symptom, and (5) State‐Trait Anxiety Inventory. Logistic analyses were used to identify factors associated with altered results. Because of multiple testing, only p‐values ≤ .01 were considered significant. Results. One hundred twelve of 175 women (64%) returned the completed questionnaires at a mean duration (standard deviation) of 6.0 (5.1) years after PBSO. QOL was positively influenced by two baseline factors: a high educational level and occupying an executive position. However, younger age at PBSO was associated with lower social functioning and greater anxiety. At the time of the study, practicing a sport and the avoidance of weight gain (≥10%) were highly related to QOL, sexual pleasure, endocrine symptoms, and anxiety in the univariate analysis and predictive of better QOL and lower anxiety in the multivariate analysis. Conclusions. Younger women and women with a low educational level and no occupation appear to be at higher risk for altered long‐term well‐being. After surgery, practicing a sport and stable weight may help maintain overall well‐being. 摘要 背景. 与一般人群相比，对于乳腺癌和/或卵巢癌遗传高危患者行预防性双侧附件切除术（PBSO）可能会因为性功能和内分泌症状等的改变而影响患者今后的生存质量。本研 究旨在探讨影响该群体远期生存质量[低生活质量（low QOL）、性功能改变、高焦虑和多内分泌症状]的相关因素。 方法. 通过电子邮件联系过去15年间在某家癌症中心接受PBSO的所有
ISSN:1083-7159
1549-490X
DOI:10.1634/theoncologist.2010-0336