Does concomitant hysterectomy impact menopausal symptoms in premenopausal BRCA1/2 pathogenic carriers undergoing risk reducing salpingo-oophorectomy?

Abstract

Prevention of high-grade serous carcinoma in women with a pathogenic variant in the BRCA1/2 genes includes prophylactic bilateral salpingo-oophorectomy (PBSO). There is debate on whether concomitant hysterectomy should be offered, with benefits including decreased risk of endometrial carcinoma and the option to use estrogen-alone menopausal hormone therapy (MHT), which is thought to be associated with better menopause-specific quality of life and lower breast cancer risk. The objective is to determine if BRCA1/2 mutation carriers undergoing premenopausal PBSO with concomitant hysterectomy have improved MENQOL compared with those women with an intact uterus.