Abstract
Hereditary Breast and Ovarian Cancer syndrome (HBOC) carriers face complex decisions, which might affect their fertility and body image. Using an anonymous 40-items questionnaire we evaluated the expectations and concerns about Risk-Reducing Surgery (RRS) in 204 carriers. Participants are well-informed about the options to manage cancer risk, and women with previous cancer are more concerned with screening failure. Satisfaction with RR Mastectomy is high, even if many carriers are unsatisfied with reconstructed breast feel and nipple-areola complex tactile sensation and those with previous breast cancer report a change in their sexual habits. The decrease of libido and vaginal dryness are the most complained symptoms after RR Salpingo-Oophorectomy. Nevertheless, most carriers would choose RRS again, due to cancer risk or screening-related stress reduction. Women who deferred RRS are more afraid of menopausal symptoms and cancer risk than those who had undergone or declined surgery. Women who declined RRS feel well-informed and trust screening procedures. In conclusion, HBOC carriers consider themselves well-informed and able to choose the best option for their condition, would choose RRS again because of cancer risk and screening-related stress reduction, and those who delay RRS face a higher preoperative level of concern and need support.
Highlights
Hereditary Breast and Ovarian Cancer (HBOC) syndrome is an inherited disorder in which specific genetic mutations are associated with an increased risk for Breast (BC) and Ovarian Cancer (OC) [1,2]
Such options include screening for BC and OC, Risk-Reducing pharmacological treatment and Risk-Reducing Surgery (RRS): bilateral prophylactic mastectomy with breast reconstruction (RRM) and Salpingo-Oophorectomy (RRSO) with or without hysterectomy [2,3,4,5]
Women belonging to the “aBRCAdaBRA Onlus” were invited to this survey while attending a meeting of members: 85 out of 187 women accepted to participate
Summary
Hereditary Breast and Ovarian Cancer (HBOC) syndrome is an inherited disorder in which specific genetic mutations (principally BRCA1 and BRCA2 genes) are associated with an increased risk for Breast (BC) and Ovarian Cancer (OC) [1,2]. Carriers should be counselled about their increased cancer risk and the options available for reducing it Such options include screening for BC and OC, Risk-Reducing pharmacological treatment and Risk-Reducing Surgery (RRS): bilateral prophylactic mastectomy with breast reconstruction (RRM) and Salpingo-Oophorectomy (RRSO) with or without hysterectomy [2,3,4,5]. Even lifestyle modifications such as regular physical exercise, normal weight or use of oral contraceptive pills [2] may play a role in cancer risk reduction. Carriers can choose the option that better suits their condition [2,5,6]
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