Surveillance of survivors: Follow-up after risk-reducing salpingo-oophorectomy in BRCA 1/2 mutation carriers
Surveillance of survivors: Follow-up after risk-reducing salpingo-oophorectomy in BRCA 1/2 mutation carriers
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DOI：
10.1016/j.ygyno.2011.04.004
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发表时间：
2011-08-01
影响因子：
4.7
通讯作者：
Chen, Lee-may
中科院分区：
文献类型：
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作者：
Chapman, Jocelyn S.;Powell, C. Bethan;Chen, Lee-may
目标.描述BRCA 1和BRCA 2突变携带者行降低风险输卵管卵巢切除术（RRSO）的术后护理特点。从我们的癌症风险项目中选择RRSO的BRCA 1和BRCA 2突变携带者被发送了关于他们手术后监测和治疗绝经症状、原发性腹膜癌和骨质流失的问卷。在RRSO后中位数为6年的51例突变携带者中，24例（47%）接受了双能X线吸收测定法（DXA）检测，每年CA-125血清检测和每年盆腔检查。三名妇女在随访中没有接受这些检查。受访者报告平均3.5更年期症状（范围0-9）。使用HRT的受访者报告的绝经期症状的平均数量为2.8，而未使用HRT的女性报告的症状为3.9（p=0.06）。6/10例（60%）报告无DXA骨扫描史的受试者和10/15例（67%）报告无术后CA-125血清监测的受试者指出，他们的医生“不建议”检测。六分之二有症状的妇女谁是年龄小于50岁（33%）谁没有其他禁忌使用HRT报告说，他们不使用是因为他们的保健提供者“反对”HRT使用。我们认为，RRSO后医疗保健指南的缺乏导致了这一队列患者的护理不一致。我们建议制定国家指南，以标准化护理，目标是优化这一独特的年轻癌症患者队列的长期生存。(C)2011 Elsevier Inc. All rights reserved.
Objectives. To characterize the post-operative care of BRCA1 and BRCA2 mutation carriers who undergo risk-reducing salpingo-oophorectomy (RRSO).Methods. BRCA1 and BRCA2 mutation carriers from our Cancer Risk Program who elected RRSO were sent questionnaires regarding their post-surgical surveillance and treatment for menopause symptoms, primary peritoneal cancer and bone loss.Results. In 51 mutation carriers who were surveyed a median of 6 years after RRSO, 24 (47%) received dual-energy X-ray absorptiometry (DXA) testing, yearly CA-125 serum testing and yearly pelvic examination. Three women received none of these examinations in follow-up. Respondents reported an average of 3.5 menopausal symptoms (range 0-9). The mean number of menopausal symptoms reported by respondents using HRT was 2.8, compared to 3.9 symptoms reported by women not using HRT (p=0.06). Six of 10 (60%) subjects who reported no history of DXA bone scan, and 10 of 15 (67%) subjects who reported no post-surgical CA-125 serum monitoring noted that their physicians "did not recommend" testing. Two out of six symptomatic women who were younger than 50(33%) who had no other contraindication to the use of HRT reported their non-use was because their care providers "advised against" HRT use.Conclusion. We believe that the lack of post-RRSO health care guidelines has resulted in inconsistent care for this cohort of patients. We proposed that national guidelines be developed to standardize care with the goal of optimizing long term survival in this unique cohort of young cancer previvors. (C) 2011 Elsevier Inc. All rights reserved.