The Effect of Prophylactic Adnexectomy on the Quality of Life and Psychosocial Functioning of Women with the BRCA1/BRCA2 Mutations.

Marta Stanisz,Elżbieta Grochans,Rafał Kurzawa,Mariusz Panczyk

doi:10.3390/ijerph16244995

Abstract

The main purpose of this study was to analyze the effect of risk-reducing salpingo-oophorectomy (RRSO) on the quality of life (QoL) and psychosocial functioning of patients with the BRCA1/BRCA2 mutations. This survey-based study was conducted using the Blatt-Kupperman Index, the Women’s Health Questionnaire, the Perceived Stress Scale, the State-Trait Anxiety Inventory, the Beck Depression Inventory-II, and the authors’ questionnaire. All calculations were done using Statistica 13.3. The QoL after RRSO was statistically significantly lower in most domains compared with the state before surgery. The greatest decline in the QoL was observed in the vasomotor symptoms domain (d = 0.953) and the smallest in the memory/concentration domain (d = 0.167). We observed a statistically significant decrease in the level of anxiety as a state (d = 0.381), as well as a statistically significant increase in the severity of climacteric symptoms (d = 0.315) and depressive symptoms (d = 0.125). Prophylactic surgeries of the reproductive organs have a negative effect on the QoL and psychosocial functioning of women with the BRCA1/2 mutations, as they increase the severity of depressive and climacteric symptoms. At the same time, these surgeries reduce anxiety as a state, which may be associated with the elimination of cancerophobia.

Highlights

BRCA1 and BRCA2 are human suppressor genes responsible for the control and regulation of the cellular cycle and the DNA repair mechanisms [1,2,3]
The analysis demonstrated statistically significant differences in the women’s quality of life (QoL) before and after prophylactic surgery of the reproductive organs
The majority of the sparse studies on the QoL of women with the BRCA1/BRCA2 mutations have been performed after prophylactic adnexectomy, and the results were compared to those obtained for the general population and patients who underwent screening

Summary

Introduction

BRCA1 and BRCA2 are human suppressor genes responsible for the control and regulation of the cellular cycle and the DNA repair mechanisms [1,2,3]. Mutations in these genes promote abnormal cell division and contribute to oncological diseases [4,5]. Estimates show that from 1 out of 800 people to 1 out of 300 people in the general population is a carrier of a mutation in one of these genes [6]. The lifetime risk of ovarian cancer in the general population is 1.5%–2%, and the risk of breast cancer is 8%–10%. About 10% of all ovarian cancer and 3%–5% of breast

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