title: How medical choices influence quality of life of women carrying a BRCA mutation.
abstract: Germline mutations in BRCA1 and BRCA2 genes were discovered twenty years ago. Female BRCA mutation carriers have an increased risk of breast and ovarian cancer at a relatively young age. Several choices have to be made with respect to cancer risk management, and consequences of these choices may affect quality of life. A review of the literature was performed to evaluate quality of life in unaffected BRCA mutation carriers and the influence of these medical choices. Overall, general quality of life appears not to be permanently affected in BRCA mutation carriers or by their choices. Risk-reducing salpingo-oophorectomy and its subsequent premature menopause affect (menopause specific) quality of life most. Hormone replacement therapy does not fully alleviate climacteric symptoms and therefore, there is a strong need for alternative strategies to reduce ovarian cancer risk and/or for improvements in postoperative care. Future research should focus on these needs.
authors: Department of Obstetrics & Gynaecology, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: Marline.Harmsen@radboudumc.nl.
authors: Marline G
authors: MG
authors: Harmsen
authors: Scientific Institute for Quality of Healthcare, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors: Rosella P M G
authors: RP
authors: Hermens
authors: Department of Medical Psychology, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors: Judith B
authors: JB
authors: Prins
authors: Department of Human Genetics, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors: Nicoline
authors: N
authors: Hoogerbrugge
authors: Department of Obstetrics & Gynaecology, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors: Joanne A
authors: JA
authors: de Hullu
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020249:Hormone Replacement Therapy; D006801:Humans; D008408:Mastectomy; D009154:Mutation / Q000235:genetics*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D010052:Ovariectomy; D057240:Patient Preference / Q000523:psychology*; D011788:Quality of Life; D012307:Risk Factors
keywords: BRCA; HRT; Menopause; Quality of life; Risk-reducing mastectomy; Risk-reducing salpingo-oophorectomy