Who is prone to high levels of distress after prophylactic mastectomy and/or salpingo-ovariectomy?
BACKGROUND
The present study aimed to assess predictors of distress after 'prophylactic mastectomy (PM) and salpingo-ovariectomy (PSO), in order to enable the early identification of patients who could benefit from psychological support.


METHODS
General distress and cancer-related distress were assessed in 82 women at increased risk of hereditary breast and/or ovarian cancer undergoing PM and/or PSO, before and 6 and 12 months after prophylactic surgery. Neurotic lability and coping were assessed before surgery.


RESULTS
Cancer-related distress and general distress at both follow-up moments were best explained by the level of cancer-related and general distress at baseline. Being a mutation carrier was predictive of increased cancer-related distress at 6-month follow-up (but not at 12 months), and of lower general distress 12 months after prophylactic surgery. Also, coping by having comforting thoughts was predictive of less cancer-related distress at 6-month follow-up.


CONCLUSIONS
Genetically predisposed women who are at risk of post-surgical distress can be identified using one or more of the predictors found in this study. Exploration of and/or attention to cancer-related distress and coping style before prophylactic surgery may help physicians and psychosocial workers to identify women who might benefit from additional post-surgical support.
Department of Medical Psychology and Psychotherapy, Erasmus Medical Centre, Leiden, The Netherlands.
P J C
PJ
Bresser
A R
AR
Van Gool
C
C
Seynaeve
H J
HJ
Duivenvoorden
M F
MF
Niermeijer
A N
AN
van Geel
M
M
Menke
J G M
JG
Klijn
A
A
Tibben
D000223:Adaptation, Psychological; D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000523:psychology; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000523:psychology; D006579:Heterozygote; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000523:psychology; D010052:Ovariectomy / Q000523:psychology*; D011446:Prospective Studies; D013315:Stress, Psychological / Q000209:etiology*