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BRCA carriers after risk-reducing bilateral salpingo-oophorectomy: menopausal hormone therapy knowledge gaps, and the impact of physicians' recommendations.
In: Climacteric, Jg. 26 (2023-04-01), Heft 2, S. 154-160
Online
academicJournal
Zugriff:
Female carriers of BRCA1/2 gene mutations are at an increased lifetime risk for breast and ovarian cancers. They are recommended to undergo risk-reducing surgery, including bilateral salpingo-oophorectomy (RR-BSO), upon completion of childbearing. RR-BSO surgery decreases morbidity and mortality but results in early menopause. Menopausal hormone therapy (MHT) is under-utilized despite being shown as safe for carriers. We aim to evaluate the factors associated with decision-making regarding MHT use following RR-BSO in healthy BRCA mutation carriers. Female carriers aged <50 years who underwent RR-BSO and were followed in a multidisciplinary clinic completed online multiple-choice and free-text questionnaires. A total of 142 women met the inclusion criteria and filled the questionnaire: 83 were MHT users and 59 were non-users. MHT users underwent RR-BSO earlier than non-users (40.82 ± 3.91 vs. 42.88 ± 4.34; p < 0.0001). MHT usage was positively associated with MHT explanation (odds ratio 4.318, 95% confidence interval [CI] [1.341–13.902], p = 0.014), and knowledge regarding the safety of MHT and its effects on general health (odds ratio 2.001, 95% CI [1.443–2.774], p < 0.0001). MHT users and non-users retrospectively evaluated their comprehension of RR-BSO consequences as significantly lower than before surgery (p < 0.001). Post-RR-BSO outcomes, including the effects on women's quality of life and its possible mitigation through MHT use, need to be addressed pre surgery by healthcare providers. [ABSTRACT FROM AUTHOR]
目的:携带BRCA1/2基因突变的女性患乳腺癌和卵巢癌的终生风险增加。建议她们在生育结束后接受降低风险的双侧输卵管卵巢切除术(RR-BSO)。RR-BSO手术降低了发病率和死亡率, 但会导致早绝经。尽管已证明绝经激素治疗(MHT)对携带者是安全的, 但仍未充分应用。我们的目标是评估健康的BRCA突变携带者在RR-BSO术后关于MHT应用决策的相关因素。 方法:对已进行RR-BSO的50岁以下女性携带者进行在线多项选择和自由文本问卷调查。 结果:共有142名女性符合纳入标准并填写了调查问卷, 其中83人应用MHT, 59人未应用MHT。应用MHT者较未应用者更早进行RR-BSO(40.82±3.91vs.42.88±4.34, P<0.0001)。MHT的应用与MHT的解释(OR 4.318, 95%CI[1.341-13.902], p=0.014)和对MHT的安全性及其对全身健康的影响的了解程度(OR 2.001, 95%CI[1.443-2.774], p<0.0001)呈正相关。应用MHT者和未应用者在术后对RR-BSO结局进行回顾性理解的效果明显低于手术前就对RR-BSO的后果进行理解(p<0.001)。 结论:RR-BSO术后的结局, 包括对女性生活质量的影响以及通过应用MHT可能得到缓解, 需要医疗保健提供者在术前告知。 [ABSTRACT FROM AUTHOR]
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Titel: |
BRCA carriers after risk-reducing bilateral salpingo-oophorectomy: menopausal hormone therapy knowledge gaps, and the impact of physicians' recommendations.
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Autor/in / Beteiligte Person: | Armon, S. ; Miron-Shatz, T. ; Mor, P. ; Tomer, A. ; Levy-Lahad, E. ; Michaelson-Cohen, R. ; Srebnik, N. |
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Zeitschrift: | Climacteric, Jg. 26 (2023-04-01), Heft 2, S. 154-160 |
Veröffentlichung: | 2023 |
Medientyp: | academicJournal |
ISSN: | 1369-7137 (print) |
DOI: | 10.1080/13697137.2023.2173567 |
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