title: Managing symptoms and maximizing quality of life after preventive interventions for cancer risk reduction.
abstract: OBJECTIVE
  The prevention of breast, ovarian and endometrial cancer frequently involves hormonal or surgical interventions. Each of these may have noncancerous sequelae and can affect quality of life in women with hereditary cancer syndromes. The purpose of this review is to discuss the medical management of hormonal suppression and surgical menopause in hereditary breast and ovarian cancer syndromes and in Lynch syndrome.
  
  
  RESULTS
  As we gain a better understanding of genetic cancer risk, we are able to reduce the development of cancer with risk-reducing surgery. Understanding the significance of noncancer outcomes helps improve surveillance and treatment strategies and improves our understanding of the interaction between our interventions and their effects on quality of life.
  
  
  CONCLUSIONS
  Advances in our understanding of the pathogenesis of hereditary breast and ovarian cancer, as well as the difference in ovarian ageing in these high-risk women, allow us to improve our counselling and interventions for family planning and risk-reducing surgery. Studies are ongoing regarding the optimal surveillance of cardiovascular and bone health after risk-reducing salpingo-oophorectomy, although more studies are needed regarding the optimal management of sexual health and other quality of life measures.
authors.affiliation: aDepartment of Obstetrics, Gynecology, and Reproductive Sciences bThe Helen Diller Family Comprehensive Cancer Center at the University of California San Francisco, San Francisco, California, USA.
authors.forename: Jocelyn S
authors.initials: JS
authors.lastname: Chapman
authors.forename: Vanessa
authors.initials: V
authors.lastname: Jacoby
authors.forename: Lee-May
authors.initials: LM
authors.lastname: Chen
mesh_terms: D001862:Bone Resorption; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology / Q000601:surgery*; D002318:Cardiovascular Diseases; D005260:Female; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005833:Genital Neoplasms, Female / Q000235:genetics / Q000523:psychology / Q000601:surgery*; D006801:Humans; D008594:Menopause, Premature / Q000523:psychology*; D010052:Ovariectomy / Q000009:adverse effects / Q000523:psychology; D011183:Postoperative Complications; D011788:Quality of Life / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D040242:Risk Reduction Behavior; D058994:Salpingectomy / Q000009:adverse effects / Q000523:psychology; D018571:Sentinel Surveillance