title: Satisfaction with ovarian carcinoma risk-reduction strategies among women at high risk for breast and ovarian carcinoma.
abstract: BACKGROUND
  Women who are at high risk for breast and ovarian cancer have 2 major management options to reduce their risk of ovarian cancer: periodic screening (PS) or risk-reducing salpingo-oophorectomy (RRSO). Little is known regarding patient satisfaction levels with risk-reduction strategies. Thus, the authors sought to determine levels of patient satisfaction with PS versus RRSO and to identify factors that may influence satisfaction.
  
  
  METHODS
  As part of a larger study, women who received testing for the breast cancer genes BRCA1 and BRCA2 were sent a follow-up questionnaire packet to explore issues related to cancer risk reduction. The authors report on the results from a variety of validated instruments, including the Satisfaction With Decision (SWD) scale, focused on the choice between PS and RRSO.
  
  
  RESULTS
  In total, 544 surveys were mailed, and 313 responses were received (58%). The overall satisfaction rate among respondents was high. The median SWD score was significantly higher in the RRSO group compared with the PS group (P < .001). BRCA mutation carriers had higher median SWD scores regardless of management type (P = .01). Low satisfaction scores were associated with high levels of uncertainty and the perception that the decision between PS and RRSO was difficult to make (P = .001). Satisfaction was unrelated to demographics, clinical factors, or concerns of cancer risk.
  
  
  CONCLUSIONS
  In the current study, the majority of women who were at high risk for breast and ovarian cancer were satisfied with their choice of risk-reduction strategy. Difficulty with decision making was associated with lower satisfaction levels. Improved education and support through the decision-making process may enhance overall levels of satisfaction.
authors.affiliation: Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Shannon N
authors.initials: SN
authors.lastname: Westin
authors.forename: Charlotte C
authors.initials: CC
authors.lastname: Sun
authors.forename: Karen H
authors.initials: KH
authors.lastname: Lu
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Schmeler
authors.forename: Pamela T
authors.initials: PT
authors.lastname: Soliman
authors.forename: Robin A
authors.initials: RA
authors.lastname: Lacour
authors.forename: Kristin G
authors.initials: KG
authors.lastname: Johnson
authors.forename: Molly S
authors.initials: MS
authors.lastname: Daniels
authors.forename: Banu K
authors.initials: BK
authors.lastname: Arun
authors.forename: Susan K
authors.initials: SK
authors.lastname: Peterson
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000517:prevention & control*; D003657:Decision Making; D055088:Early Detection of Cancer; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000517:prevention & control*; D010052:Ovariectomy; D017060:Patient Satisfaction; D011322:Primary Prevention / Q000379:methods*; D011788:Quality of Life; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires