The effect of hormone therapy on quality of life and breast cancer risk after risk-reducing salpingo-oophorectomy: a systematic review.
It is unclear if the use of hormone therapy (HT) in carriers of BRCA mutations improves the quality of life (QOL) without increasing the risk of breast cancer following a risk-reducing salpingo-oophorectomy (RRSO). Our objective was to assess the effect of HT on QOL and breast cancer risk, after RRSO.



We searched MEDLINE, EMBASE, CINHAL, and others, from inception to July 22, 2016, to identify relevant studies. Two reviewers independently screened identified records for controlled trials and observational studies that addressed the effect of HT on QOL and breast cancer risk in women with BRCA mutations, post RRSO. Two reviewers independently extracted data on populations, interventions, comparators, outcomes, and methodological quality. Studies addressing the same outcome were synthesized using written evidence summaries or tables.



Of the 1,059 records identified, 13 met our inclusion criteria. All studies were observational. Six studies assessed the effect on QOL. Of these, 3 showed improvement in QOL with HT use. The risk of breast cancer was evaluated in 4 studies. The mean duration of follow-up was 2.6 years (range 0.1-19.1). The risk of breast cancer did not change with HT use in all 4 studies.



Cumulative evidence from our review suggests that short-term HT use following RRSO improves QOL. The effect on breast cancer risk is still unclear. There are too few long-term studies to draw any strong conclusions. The need for future well-designed RCTs for more established evidence is imperative.
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, T6G 1C9, Canada.
Tasneem
T
Siyam
Cavarzan Chair in Mature Women's Health Research, Department of Obstetrics and Gynecology, Rm 5S131 Lois Hole Hospital/Robbins Pavilion Royal Alexandra Hospital, 10240 Kingsway Ave, Edmonton, AB, T5H 3V9, Canada.
Sue
S
Ross
2K4.01 WC Mackenzie Health Science Center, University of Alberta, Edmonton, AB, T6G 2R7, Canada.
Sandra
S
Campbell
School of Public Health, 2-040 Li Ka Shing HRIF, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
Dean T
DT
Eurich
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, T6G 1C9, Canada. nese.yuksel@ualberta.ca.
Nesé
N
Yuksel
D001943:Breast Neoplasms / Q000401:mortality*; D005260:Female; D019398:Genes, BRCA1; D020249:Hormone Replacement Therapy / Q000523:psychology*; D006801:Humans; D010052:Ovariectomy / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D040242:Risk Reduction Behavior; D058994:Salpingectomy / Q000523:psychology*
BRCA1/2; Breast cancer; Hormone Therapy; QOL; RRSO