Abstract
Objective: BRCA 1 and 2 mutation carriers are invited to follow intensive clinical and instrumental surveillance programs or are offered prophylactic ovarian surgery. These recommendations impact many aspects of their lives. The primary objective of this study was to assess the overall quality of life (HRQoL) before and after prophylactic bilateral salpingo-oophorectomy (BSO). Secondary objectives were investigating sexual health (SH) and fatigue severity state. Design: This was a single-center retrospective observational study. Setting: Women who underwent surgical treatment of bilateral salpingo-oophorectomy between 2018 and 2024 at “DAI Materno Infantile” of Azienda Ospedaliera Universitaria “Federico II” of Naples were included. Methods: These patients were tracked down to undergo specific questionnaires, such as “Global Health Status (GHS) and Quality of Life Scale (QOL) (EORTC QLQ-C30),” “EORTC Sexual Health Questionnaire (QLQ-SH22),” and “Fatigue Severity Scale (FSS),” to evaluate their psychological, sexual, and general physical condition impact before the surgery, 3 and 6 months later. Results: The overall mean QoL score was 88.3 ± 29.8 (mean ± standard deviation), and this score worsened when the surgery was performed at 3 months (p < 0.0001) with a score of 51.7 ± 30.7 and a mean difference (MD) of 36.6 points; instead, at 6 months, the overall mean QoL score was 73.1 ± 24.3 with an MD of 21.4 points. FSS reported a score of 2.7 ± 1.15 vs 4.2 ± 1.59 (p < 0.0001) vs 3.5 ± 1.43 (p < 0.0001), respectively, before and 3–6 months after surgery. EORTC QLQ-SH22 before and after treatment showed statistically significant changes in sexual satisfaction (p < 0.0001). Conclusion: BSO may impact the quality of life regardless of the hormonal status of patients related to age or menopause, about both the functional evaluation and the psychological and emotional assessment report. The physical change related to the surgical procedure is associated with a mental shift that affects both the physical and sexual energy of our patients in the first 3 months postoperatively, with a slight improvement of these data at 6 months.
Plain Language Summary
This study aims to improve the clinician’s approach for a complete medical and psychological evaluation of patients with BRCA mutation carriers, so they can be best accompanied during their surgical procedure. Guidelines recommend performing RRSO at the age of 35–40 years for BRCA1 mutation carriers. Instead, BRCA2 mutation carriers can delay it until the age of 40–45 years. Although surgery can reduce anxiety associated with developing cancer risk, the impact on physical and mental health and quality of life must be considered. The aim of the study was to evaluate the overall quality of life as well as psychological, sexual, and physical conditions in women carriers of BRCA1/BRCA2 mutations before and after prophylactic BSO. Patients were evaluated before starting any hormone replacement therapy (HRT) by verifying important changes in all life’s aspects regardless of age or medical history.
