Care after premenopausal risk-reducing salpingo-oophorectomy in high-risk women: Scoping review and international consensus recommendations

Denise R Nebgen; Susan M Domchek; Joanne Kotsopoulos; Joanne A de Hullu; Emma J Crosbie; Vincent Singh Paramanandam; Monique M A Brood-van Zanten; Barbara M Norquist; Theresa Guise; Serge Rozenberg; Allison W Kurian; Holly J Pederson; Nese Yuksel; Rachel Michaelson-Cohen; Sharon L Bober; Agnaldo Lopes da Silva Filho; Nora Johansen; F Guidozzi; D Gareth Evans; Usha Menon; Sheryl A Kingsberg; C Bethan Powell; Giovanni Grandi; Claudia Marchetti; Michelle Jacobson; Donal J Brennan; Martha Hickey

doi:10.1111/1471-0528.17511

Care after premenopausal risk-reducing salpingo-oophorectomy in high-risk women: Scoping review and international consensus recommendations

BJOG. 2023 Nov;130(12):1437-1450. doi: 10.1111/1471-0528.17511. Epub 2023 May 2.

Authors

Denise R Nebgen¹, Susan M Domchek², Joanne Kotsopoulos³, Joanne A de Hullu⁴, Emma J Crosbie⁵, Vincent Singh Paramanandam⁶, Monique M A Brood-van Zanten⁷, Barbara M Norquist⁸, Theresa Guise⁹, Serge Rozenberg¹⁰, Allison W Kurian¹¹, Holly J Pederson¹², Nese Yuksel¹³, Rachel Michaelson-Cohen¹⁴, Sharon L Bober¹⁵, Agnaldo Lopes da Silva Filho¹⁶, Nora Johansen¹⁷, F Guidozzi¹⁸, D Gareth Evans¹⁹, Usha Menon²⁰, Sheryl A Kingsberg²¹, C Bethan Powell²², Giovanni Grandi²³, Claudia Marchetti²⁴, Michelle Jacobson²⁵, Donal J Brennan²⁶, Martha Hickey²⁷

Affiliations

¹ Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
² Basser Center for BRCA, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
³ Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
⁴ Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands.
⁵ Division of Cancer Sciences, University of Manchester, St Mary's Hospital, Manchester, UK.
⁶ Department of Obstetrics and Gynaecology, The Royal Women's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
⁷ Department of Gynecology, The Netherlands Cancer Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
⁸ Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA.
⁹ Department of Endocrine Neoplasia and Hormone Disorders, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
¹⁰ Department of Obstetrics and Gynaecology, Universite Libre de Bruxelles, Brussels, Belgium.
¹¹ Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California, USA.
¹² Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA.
¹³ Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
¹⁴ Department of Gynaecology and Medical Genetics Institute, Hebrew University Faculty of Medicine, Shaare Zedek Medical Centre, Jerusalem, Israel.
¹⁵ Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA.
¹⁶ Departamento de Ginecologia e Obstetricia da UFMG, Federal University of Minas Gerais, Belo Horizonte, Brazil.
¹⁷ Department of Gynaecology and Obstetrics, Sørlandet Hospital HF Arendal, Arendal, Norway.
¹⁸ Deparment of Obstetrics and Gynaecology, University of Witwatersrand, Johanesburg, South Africa.
¹⁹ University of Manchester, Prevent Breast Cancer Centre, Manchester, UK.
²⁰ MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK.
²¹ University Hospitals Cleveland Medical Center, Case Western University School of Medicine, Cleveland, Ohio, USA.
²² Kaiser Permanente Northern California, Hereditary Cancer Program, San Francisco, California, USA.
²³ Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy.
²⁴ Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Catholic University Sacred Heart, Rome, Italy.
²⁵ Women's College Hospital and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
²⁶ UCD Gynaecological Oncology Group, UCD School of Medicine, Mater University Hospital, Dublin, Ireland.
²⁷ Department of Obstetrics and Gynaecology, Research Precinct, Level 7, The Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia.

PMID: 37132126
DOI: 10.1111/1471-0528.17511

Abstract

Women at high inherited risk of ovarian cancer are offered risk-reducing salpingo-oophorectomy (RRSO) from age 35 to 45 years. Although potentially life-saving, RRSO may induce symptoms that negatively affect quality of life and impair long-term health. Clinical care following RRSO is often suboptimal. This scoping review describes how RRSO affects short- and long-term health and provides evidence-based international consensus recommendations for care from preoperative counselling to long-term disease prevention. This includes the efficacy and safety of hormonal and non-hormonal treatments for vasomotor symptoms, sleep disturbance and sexual dysfunction and effective approaches to prevent bone and cardiovascular disease.

Keywords: BRCA1; BRCA2; early menopause; hormone replacement therapy; hot flushes; ovarian cancer; risk-reducing salpingo-oophorectomy; sexual function; surgical menopause.

Publication types

Review

MeSH terms

Adult
Consensus
Female
Genetic Predisposition to Disease
Humans
Middle Aged
Ovarian Neoplasms* / genetics
Ovarian Neoplasms* / prevention & control
Ovarian Neoplasms* / surgery
Ovariectomy
Premenopause
Quality of Life
Salpingo-oophorectomy*

Grants and funding

MC_UU_00004/01/MRC_/Medical Research Council/United Kingdom