title: Surveillance of survivors: follow-up after risk-reducing salpingo-oophorectomy in BRCA 1/2 mutation carriers.
abstract: OBJECTIVE
  To characterize the post-operative care of BRCA1 and BRCA2 mutation carriers who undergo risk-reducing salpingo-oophorectomy (RRSO).
  
  
  METHODS
  BRCA1 and BRCA2 mutation carriers from our Cancer Risk Program who elected RRSO were sent questionnaires regarding their post-surgical surveillance and treatment for menopause symptoms, primary peritoneal cancer and bone loss.
  
  
  RESULTS
  In 51 mutation carriers who were surveyed a median of 6 years after RRSO, 24 (47%) received dual-energy X-ray absorptiometry (DXA) testing, yearly CA-125 serum testing and yearly pelvic examination. Three women received none of these examinations in follow-up. Respondents reported an average of 3.5 menopausal symptoms (range 0-9). The mean number of menopausal symptoms reported by respondents using HRT was 2.8, compared to 3.9 symptoms reported by women not using HRT (p=0.06). Six of 10 (60%) subjects who reported no history of DXA bone scan, and 10 of 15 (67%) subjects who reported no post-surgical CA-125 serum monitoring noted that their physicians "did not recommend" testing. Two out of six symptomatic women who were younger than 50 (33%) who had no other contraindication to the use of HRT reported their non-use was because their care providers "advised against" HRT use.
  
  
  CONCLUSIONS
  We believe that the lack of post-RRSO health care guidelines has resulted in inconsistent care for this cohort of patients. We proposed that national guidelines be developed to standardize care with the goal of optimizing long term survival in this unique cohort of young cancer previvors.
authors.affiliation: UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA 94143, USA.
authors.forename: Jocelyn S
authors.initials: JS
authors.lastname: Chapman
authors.forename: C Bethan
authors.initials: CB
authors.lastname: Powell
authors.forename: Jane
authors.initials: J
authors.lastname: McLennan
authors.forename: Beth
authors.initials: B
authors.lastname: Crawford
authors.forename: Julie
authors.initials: J
authors.lastname: Mak
authors.forename: Nicola
authors.initials: N
authors.lastname: Stewart
authors.forename: Lee-May
authors.initials: LM
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D018394:CA-125 Antigen / Q000097:blood; D015914:Estrogen Replacement Therapy; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006579:Heterozygote; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D010051:Ovarian Neoplasms / Q000517:prevention & control*; D010052:Ovariectomy; D017741:Survivors
chemical_list: D018394:CA-125 Antigen