title: Hormone therapy in oophorectomized BRCA1/2 mutation carriers.
abstract: OBJECTIVE
  BRCA1/2 mutation carriers have greatly elevated lifetime risks of breast, ovarian, and fallopian tube cancers. Bilateral prophylactic salpingo-oophorectomy is recommended to prevent cancer in these women. As it is often performed before natural menopause, it may be accompanied by menopausal symptoms, impaired quality of life, and increased cardiovascular risk.
  
  
  METHODS
  In this review, we describe the indications, timing, and implications of salpingo-oophorectomy for BRCA-positive women, with a special focus on the risks and benefits of hormone therapy (HT). Furthermore, retrospective and prospective trials of HT in BRCA mutation carriers undergoing prophylactic salpingo-oophorectomy are debated.
  
  
  RESULTS
  Hormonal deprivation after prophylactic salpingo-oophorectomy may negatively impact health and quality of life; most women experience menopausal symptoms shortly after surgical operation. Literature data suggest that HT generally reduces vasomotor symptoms related to surgical menopause, improving sexual functioning without affecting survival.
  
  
  CONCLUSIONS
  Despite the limitations of retrospective and prospective observational studies, short-term HT seems to improve quality of life and does not seem to have an adverse effect on oncologic outcomes in BRCA1 and BRCA2 mutation carriers without a personal history of breast cancer. Therefore, randomized and larger trials are urgently needed.
authors.affiliation: From the Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Marchetti
authors.forename: Roberta
authors.initials: R
authors.lastname: Iadarola
authors.forename: Innocenza
authors.initials: I
authors.lastname: Palaia
authors.forename: Violante
authors.initials: V
authors.lastname: di Donato
authors.forename: Giorgia
authors.initials: G
authors.lastname: Perniola
authors.forename: Ludovico
authors.initials: L
authors.lastname: Muzii
authors.forename: Perluigi Bendetti
authors.initials: PB
authors.lastname: Panici
mesh_terms: D001943:Breast Neoplasms / Q000517:prevention & control; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005185:Fallopian Tube Neoplasms / Q000517:prevention & control; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D019584:Hot Flashes / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D010051:Ovarian Neoplasms / Q000517:prevention & control; D010052:Ovariectomy / Q000009:adverse effects*; D011182:Postoperative Care / Q000379:methods; D012489:Salpingostomy / Q000009:adverse effects*