Quality of life in BRCA1 and BRCA2 mutation carriers (B1/2) following risk-reducing salpingo-oophorectomy (RRSO).

Cancer Prevention/Epidemiology
Session Type and Session Title: 
Oral Abstract Session, Cancer Prevention/Epidemiology
Abstract Number: 
J Clin Oncol 32:5s, 2014 (suppl; abstr 1508)
Susan M. Domchek, Jiaqi Li, Laura Digiovanni, Chan Voong, Rebecca Mueller, Lauren Johnson, C. Neill Epperson, Sue Friedman, Clarisa Gracia; University of Pennsylvania, Philadelphia, PA; Basser Research Center for BRCA, University of Pennsylvania,, Philadelphia, PA; Facing our Risk of Cancer Empowered, Tampa, FL; Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).

Abstract Disclosures


Background: RRSO is associated with a decreased risk of breast cancer, ovarian cancer and improved survival in B1/2. Timing of RRSO must balance the known benefits against the impact of early menopause. A better understanding of the long term impact of RRSO is required to aid decision making. Methods: B1/2 were ascertained from FORCE, a national advocacy group for hereditary breast and ovarian cancer. Demographics and medical history were obtained by online questionnaires. QOL measures evaluated executive cognition function (BADDS), menopausal symptoms (Greene), sexual function (FSFI), sleep (PSQI), stress (PSS), anxiety (HADS-A), and depression (HADS-D). Results: 637 B1/2 with RRSO were enrolled. Median age was 47. Median age of RRSO was 45. 43% had prior cancer history (of whom 87% had breast cancer and of these 60% chemotherapy). 27% were currently using HRT. Self reported HTN was present in 14%, osteopenia/osteoporosis in 32%, and depression in 36%. Suboptimal scores were present in the majority of patients for the majority of measures: specifically 60% of BADDS, 57% of Greene vasomotor, 73% of FSFI, 61% of PSQI, 56% of PSS, 16% of HADS-A, and 15% of HADS-D scores fell in the abnormal range. Earlier age of oophorectomy predicted suboptimal scores in sleep, stress, menopausal symptoms, anxiety and depression scales (p<0.04 for each). High school education or less (compared to some college or more) predicted poorer results in stress, anxiety, sexual functioning and menopausal symptoms (p<0.02 for each). Single status (as opposed to married or living as married) was associated with poorer scores on stress and sleep scales (p<0.01). In the subgroup of B1/2 with no cancer history and RRSO <50 years-old, current HRT use was associated with improved sleep (p=0.02) and vasomotor symptoms (p<0.0001). Conclusions: In this large series of B1/2 ascertained through FORCE, the majority of women reported sexual dysfunction, menopausal symptoms, cognitive issues, and poor sleep. Interventions are needed to mitigate the negative impact of RRSO.