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Predictors of prophylactic bilateral salpingo-oophorectomy compared with gynecologic screening use in BRCA1/2 mutation carriers.

Joanna B Madalinska ,
Marc van Beurden ,
Eveline M A Bleiker ,
Heiddis B Valdimarsdottir ,
Lottie Lubsen-Brandsma ,
Leon F Massuger ,
Marian J E Mourits ,
Katja N Gaarenstroom ,
Eleonora B L van Dorst ,
Hans van der Putten ,
Henk Boonstra ,
Neil K Aaronson

Abstract

PATIENTS AND METHODS

Baseline questionnaires were available from 160 BRCA1/2 carriers who participated in a nationwide, longitudinal, observational study of the psychosocial consequences of prophylactic surgery versus periodic screening. Topics addressed by the questionnaire included generic quality of life, cancer-specific distress, risk perception, knowledge of ovarian cancer, and perceived pros and cons of surgery versus screening. PBSO use during the 12-month period after the first gynecologic consultation was determined on the basis of medical record data.

CONCLUSION

Women with lower educational levels, with poorer general health perceptions, who view ovarian cancer as an incurable disease, and who believe more strongly in the benefits of surgery are more likely to undergo PBSO. Clinicians should ensure that high-risk women are well informed about the low predictive value of GS techniques and about the lethal threat posed by ovarian cancer because of its limited curability.

RESULTS

During the 12-month follow-up period, 74% of women had undergone PBSO, and 26% opted for screening. Statistically significant multivariate predictors of PBSO included education, general health perceptions, perceived incurability of ovarian cancer, and perceived benefits of surgery.

PURPOSE

Women with BRCA1/2 gene mutations who have completed their childbearing are strong candidates for risk-reducing prophylactic bilateral salpingo-oophorectomy (PBSO). The aim of the current study was to identify baseline predictors of PBSO versus gynecologic screening (GS) in this group of high-risk women.

More about this publication

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

Volume 25
Issue nr. 3
Pages 301-7
Publication date 20-01-2007

Full text links

Publisher website (DOI) 10.1200/JCO.2006.07.4922
Europe PubMed Central 17235045
Pubmed 17235045

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