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Prophylactic Oophorectomy

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61. Prophylactic oophorectomy with colorectal cancer resection: a systematic review and meta-analysis

Prophylactic oophorectomy with colorectal cancer resection: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address

2014 PROSPERO

62. A simulation model to predict the impact of prophylactic surgery and screening on the life expectancy of BRCA1 and BRCA2 mutation carriers. (PubMed)

A simulation model to predict the impact of prophylactic surgery and screening on the life expectancy of BRCA1 and BRCA2 mutation carriers. Women with inherited mutations in the BRCA1 or BRCA2 (BRCA1/2) genes are recommended to undergo a number of intensive cancer risk-reducing strategies, including prophylactic mastectomy, prophylactic oophorectomy, and screening. We estimate the impact of different risk-reducing options at various ages on life expectancy.We apply our previously developed (...) Monte Carlo simulation model of screening and prophylactic surgery in BRCA1/2 mutation carriers. Here, we present the mathematical formulation to compute age-specific breast cancer incidence in the absence of prophylactic oophorectomy, which is an input to the simulation model, and provide sensitivity analysis on related model parameters.The greatest gains in life expectancy result from conducting prophylactic mastectomy and prophylactic oophorectomy immediately after BRCA1/2 mutation testing

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2012 Cancer Epidemiology & Biomarkers and Prevention

63. Preoperative Risk Assessment Among Women Undergoing Bilateral Prophylactic Mastectomy for Cancer Risk Reduction. (PubMed)

Preoperative Risk Assessment Among Women Undergoing Bilateral Prophylactic Mastectomy for Cancer Risk Reduction. Cancer risk assessment is an important decision-making tool for women considering irreversible risk-reducing surgery. Our objective was to determine the prevalence of BRCA testing among women undergoing bilateral prophylactic mastectomy (BPM) and to review the characteristics of women who choose BPM within a metropolitan setting.We retrospectively reviewed records of women who (...) not tested.From January 2002 to July 2009, a total of 71 BPMs were performed. Only 25 women (35.2%) had preoperative BRCA testing; 88% had a BRCA mutation. Compared with tested women, BRCA nontested women were significantly older (39.1 vs. 49.2 years, P < 0.001), had significantly more preoperative biopsies and mammograms and had fewer previous or simultaneous cancer risk-reducing surgery (oophorectomy). Among BRCA nontested women, common indications for BPM were family history of breast cancer (n = 21, 45.6

2011 Annals of Surgical Oncology

64. Oophorectomy

the risks associated with removal of ovaries. However, it is now clear that prophylactic oophorectomy without a reasonable medical indication decreases long-term survival rates substantially and has deleterious long-term effects on health and well-being even in post-menopausal women. The procedure has been postulated as a possible treatment method for female sex offenders. Cancer prevention [ ] Oophorectomy can significantly improve survival for women with high-risk , for whom oophorectomy around age 40 (...) together with prophylactic . It is important to understand that the risks and benefits associated with oophorectomy in the BRCA1/2 mutation carrier population are different than those for the general population. Prophylactic risk-reducing salpingo-oophorectomy (RRSO) is an important option for the high-risk population to consider. Women with BRCA1/2 mutations who undergo salpingo-oophorectomy have lower all-cause mortality rates than women in the same population who do not undergo this procedure

2012 Wikipedia

65. Single-port risk-reducing salpingo-oophorectomy with and without hysterectomy: Surgical outcomes and learning curve analysis. (PubMed)

Single-port risk-reducing salpingo-oophorectomy with and without hysterectomy: Surgical outcomes and learning curve analysis. Based on considerable prospective data, risk-reducing salpingo-oophorectomy (RRSO) is one of the most beneficial interventions available to reduce ovarian/breast cancer risk in BRCA carriers and high-risk women. The purpose of this study was to describe the initial surgical outcomes and learning curve analysis associated with laparoendoscopic single-site (LESS) RRSO (...) (63%) were BRCA1/2 carriers and 38 (63%) had breast cancer. Patients' mean age and BMI were 46 years and 27 kg/m(2), respectively. Most patients were Caucasian (76%), and at the time of prophylactic surgery, 53% of patients were undergoing active breast cancer treatment. Mean operative time was 38.1 minutes (16-80 minutes). All cases were performed successfully via the LESS approach, and there were no surgical complications. Multivariate linear regression analysis was done, and after controlling

2010 Gynecologic Oncology

66. Cancer antigen 125 level after a bilateral salpingo-oophorectomy: what is the contribution of the ovary to the cancer antigen 125 level? (PubMed)

Cancer antigen 125 level after a bilateral salpingo-oophorectomy: what is the contribution of the ovary to the cancer antigen 125 level? Serum cancer antigen (CA) 125 is the only biomarker used frequently in women with or at risk for ovarian cancer. However, the same reference level is used before and after (prophylactic) bilateral salpingo-oophorectomy (BSO). We evaluated the effect of BSO on CA125 level in BRCA mutation carriers and tested which factors interact with the change in CA125 (...) level.All women who participated in the Nijmegen gynecological screening program and underwent prophylactic BSO were included. Information was obtained on age, smoking, menopausal state, previous hysterectomy and breast cancer, histopathological examination of the adnexa, hormone therapy use, and CA125 level before and after surgical operation. Ovarian volume was calculated. The logarithmic-transformed CA125 levels were used in a linear mixed model to study the relative change in CA125 level

2010 Menopause

67. New Strategies in Ovarian Cancer: Uptake and experience of women at high risk of ovarian cancer who are considering risk-reducing salpingo-oophorectomy. (PubMed)

New Strategies in Ovarian Cancer: Uptake and experience of women at high risk of ovarian cancer who are considering risk-reducing salpingo-oophorectomy. Here, we review factors associated with uptake of risk-reducing salpingo-oophorectomy by women at increased hereditary risk for ovarian cancer, as well as quality of life issues following surgery. Forty-one research studies identified through PubMed and PsychInfo met inclusion criteria. Older age, having had children, a family history (...) of ovarian cancer, a personal history of breast cancer, prophylactic mastectomy, and BRCA1/2 mutation carrier status increase the likelihood of undergoing surgery. Psychosocial variables predictive of surgery uptake include greater perceived risk of ovarian cancer and cancer-related anxiety. Most women report satisfaction with their decision to undergo surgery and both lower perceived ovarian cancer risk and less cancer-related anxiety as benefits. Hormonal deprivation is the main disadvantage reported

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2010 Clinical Cancer Research

68. Risk-reducing mastectomy and salpingo-oophorectomy in unaffected BRCA mutation carriers: uptake and timing. (PubMed)

found a 10-year uptake of 75% for risk-reducing salpingo-oophorectomy and 50% for risk-reducing mastectomy by time to event analysis. Age and childbirth influenced this decision. The uptake rate has not changed significantly over the last decade. Risk-reducing surgeries are widely acceptable among Danish BRCA mutation positive women and the uptake of prophylactic mastectomy is higher than in most other countries. (...) Risk-reducing mastectomy and salpingo-oophorectomy in unaffected BRCA mutation carriers: uptake and timing. Once female carriers of a BRCA mutation are identified they have to make decisions on risk management. The aim of this study is to outline the uptake of risk-reducing surgery in the Danish population of BRCA mutation positive women and to search for factors affecting this decision. We analysed data from 306 healthy BRCA carriers with no personal history of ovarian or breast cancer. We

2010 Clinical Genetics

69. Prophylactic mastectomy: Breast cancer prevention for high-risk women

options Other options for early detection and risk reduction include: Breast cancer screening. Your doctor may suggest mammogram and MRI every year. Screening should also involve an annual clinical breast exam by your doctor and breast-awareness education to familiarize you with the normal consistency of your breast tissue. Surgery to remove the ovaries (prophylactic oophorectomy). This procedure can reduce the risk of both breast and ovarian cancers. In women at high risk of breast cancer (...) , prophylactic oophorectomy may reduce that risk by up to 50 percent if the procedure is done before age 50, when women are premenopausal. Healthy lifestyle. Maintaining a healthy weight, exercising most days of the week, limiting alcohol use and avoiding hormone therapy during menopause may reduce the risk of breast cancer. Eating a healthy diet might decrease your risk of some types of cancer, as well as diabetes, heart disease and stroke. For example, women who eat a Mediterranean diet supplemented

2009 Mayo Decision Aids

70. Long-term risks of prophylactic oophorectomy compared to ovary preservation at the time of hysterectomy for benign indications

Long-term risks of prophylactic oophorectomy compared to ovary preservation at the time of hysterectomy for benign indications Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne

2013 PROSPERO

71. Prophylactic mastectomy for the prevention of breast cancer. (PubMed)

for multiple differences between intervention groups and this study showed no overall survival advantage for CPM at 15 years. Another study showed significantly improved survival following CPM but after adjusting for bilateral prophylactic oophorectomy, the CPM effect on all-cause mortality was no longer significant.Sixteen studies assessed psychosocial measures; most reported high levels of satisfaction with the decision to have PM but more variable satisfaction with cosmetic results. Worry over breast (...) Prophylactic mastectomy for the prevention of breast cancer. Recent progress in understanding the genetic basis of breast cancer has increased interest in prophylactic mastectomy (PM) as a method of preventing breast cancer.(i) To determine whether prophylactic mastectomy reduces death rates from any cause in women who have never had breast cancer and in women who have a history of breast cancer in one breast, and (ii) to examine the effect of prophylactic mastectomy on other endpoints

2010 Cochrane database of systematic reviews (Online)

72. Breast and ovarian cancer risk perception after prophylactic salpingo-oophorectomy due to an inherited mutation in the BRCA1 or BRCA2 gene. (PubMed)

Breast and ovarian cancer risk perception after prophylactic salpingo-oophorectomy due to an inherited mutation in the BRCA1 or BRCA2 gene. It is often recommended that women who carry a mutation in the BRCA1 or BRCA2 gene have their ovaries and fallopian tubes removed to reduce their risk of gynecologic cancer. The aim of this study was to evaluate women's perception of their risk of breast and ovarian cancer before and after prophylactic salpingo-oophorectomy. We surveyed 127 women who carry (...) a BRCA1 or BRCA2 mutation and who underwent prophylactic salpingo-oophorectomy at the University Health Network, Toronto. Subjects were asked to estimate their risks of breast and ovarian cancer before and after surgery. Their perceived risks of cancers were then compared with published risks, based on their mutation status. BRCA1 carriers estimated their risk of breast cancer risk to be, on average, 69% before surgery and 41% after surgery. They estimated their risk of ovarian cancer to be 55% before

2009 Clinical Genetics

73. Clinical Utility Card - Heritable mutations which increase risk in colorectal and endometrial cancer

more intensive surveillance Endometrial and ovarian ? hysterectomy and risk reducing salpingo-oophorectomy (RRSO) are interventions which significantly reduce the risk of both endometrial and ovarian cancer Familial adenomatous polyposis ? systematic reviews have found that registration in dedicated registers, surveillance and colectomy are associated with a consistent and significant reduction in incidence and CRC-related mortality 12. Economic evaluation Stepped results of the economic analyses (...) $2,053,227 Predictive tests $340 $380,564 $386,765 $392,927 $399,077 $405,210 Genetic counselling $337 $957,450 $973,051 $988,552 $1,004,026 $1,019,455 Total net cost to MBS of genetic testing and counselling $3,266,361 $3,319,585 $3,372,468 $3,425,258 $3,477,892 MBS = Medicare Benefits Schedule However these estimates do not consider the anticipated downstream costs or savings associated with surveillance, prophylactic surgeries or cancer treatments. A significant proportion of these downstream services

2019 Medical Services Advisory Committee

74. Position Statement – Testing for ovarian cancer in asymptomatic women: Technical Report

subgroups such as stage at diagnosis are examined, further reducing the certainty of the outcomes. Interpretation of the results of these surveillance studies also requires consideration of the fact that risk-reducing salpingo- oophorectomy (RRSO) is recommended as optimal management. The PLCO-HR subgroup analysis overcomes many of the limitations described above. However, it was not feasible to identify women in this study post hoc according to the usual array of criteria that define high risk (...) be recommended for routine use in a population screening setting. Surveillance of women at high or potentially high risk of ovarian cancer ? Ovarian cancer surveillance is not recommended for women at high or potentially high risk. ? Evidence shows that ultrasound or CA125, singly or in combination, is not effective at detecting early ovarian cancer. ? The most effective risk reducing strategy for ovarian cancer is bilateral salpingo-oophorectomy. Definition of potentially high risk women The category

2019 Cancer Australia

75. Hysterectomy

when conservative therapy has failed to control bleeding (II-B). 2. Tubo-ovarian abscesses that are ruptured or do not respond to antibiotics may be treated with hysterectomy and bilateral salpingo-oophorectomy in selected cases (I-C). 3. Hysterectomy may be required for cases of acute menorrhagia refractory to medical or conservative surgical treatment (II-C). Other Indications 1. Consultation with an oncologist or geneticist is recommended when considering hysterectomy and prophylactic (...) oophorectomy for a familial history of ovarian cancer (III-C). Surgical Approach 1. The vaginal route should be considered as a first choice for all benign indications. The laparoscopic approach should be considered when it reduces the need for a laparotomy (III-B). Validation Medline searches were performed in preparing this guideline with input from experts in their field across Canada. The guideline was reviewed and accepted by SOGC Council and Executive. Sponsor The Society of Obstetricians

2018 Society of Obstetricians and Gynaecologists of Canada

76. Placenta Accreta Spectrum

( , ). The dose should be 1 g intravenously within 3 hours of birth. A second dose may be given 0.5–23.5 hours later if bleeding persists (75). Prophylactic tranexamic acid given at the time of delivery after cord clamping may reduce the risk of hemorrhage with placenta accreta spectrum. A recent meta-analysis showed decreased bleeding when tranexamic acid is given prophylactically at the time of cesarean delivery ( ). However, many of the studies had flawed designs or small numbers of patients, and rare (...) but serious adverse events such as renal cortical necrosis have been reported with postpartum use ( ). It is noteworthy that women with this complication received considerably higher doses than are currently recommended (75, 78). Nonetheless, prophylactic use is not currently advised for routine cesarean delivery and large studies are ongoing. Prophylactic use in placenta accreta spectrum is unstudied. Several other clotting factors may help in cases of refractory bleeding. In the past, the goal

2019 American College of Obstetricians and Gynecologists

77. Opportunistic Salpingectomy as a Strategy for Epithelial Ovarian Cancer Prevention

pelvic surgery about the risks and benefits of salpingectomy should include an informed consent discussion about the role of oophorectomy and bilateral salpingo-oophorectomy. Bilateral salpingo-oophorectomy that causes surgical menopause reduces the risk of ovarian cancer but may increase the risk of cardiovascular disease, cancer other than ovarian cancer, osteoporosis, cognitive impairment, and all-cause mortality. Salpingectomy at the time of hysterectomy or as a means of tubal sterilization (...) , readmissions, and postoperative complications, infections, or fever compared with hysterectomy alone or tubal ligation. Ovarian function does not appear to be affected by salpingectomy at the time of hysterectomy based on surrogate serum markers or response to in vitro fertilization. The surgeon and patient should discuss the potential benefits of the removal of the fallopian tubes during a hysterectomy in women at population risk of ovarian cancer who are not having an oophorectomy. Counseling women who

2019 American College of Obstetricians and Gynecologists

78. Information for women considering preventive mastectomy

Partnership Grant from 4 This booklet is intended for women with a strong family history of breast cancer who may be considering the option of surgical removal of their breasts as a way of reducing their risk of developing breast cancer. This type of surgery is known as preventive or prophylactic mastectomy. If this is you, this booklet presumes that you have already attended a family cancer service (or other genetic counselling service), breast surgeon or oncologist to discuss in detail your breast (...) preventive oophorectomy (surgery to remove ovaries to reduce ovarian cancer risk), an additional consideration may be needed if their preference is to use their own tissue for reconstruction. The reason for this is that a mesh is used to rebuild the area where the tissue is taken from the abdomen for breast reconstruction. This mesh would need to be cut to perform the oophorectomy, creating a slightly weaker mesh after the surgery. CC mastectomy booklet[V8].indd 18 22/10/08 8:40:29 PM19 Some questions

2019 European Society of Endocrinology

79. BRCA-Related Cancer: Risk Assessment, Genetic Counseling, and Genetic Testing

mastectomy and salpingo-oophorectomy. Additional Tools and Resources The National Cancer Institute Cancer Genetics Services Directory provides a list of professionals who offer services related to cancer genetics, including cancer risk assessment, genetic counseling, and genetic testing. Other Related USPSTF Recommendations The USPSTF recommends that clinicians offer to prescribe risk-reducing medications such as tamoxifen, raloxifene, or aromatase inhibitors to women at increased risk for breast cancer (...) cancer screening (eg, earlier and more frequent mammography or magnetic resonance imaging [MRI] of the breast), medications (eg, tamoxifen, raloxifene, or aromatase inhibitors), and risk-reducing surgery (eg, mastectomy or salpingo-oophorectomy). Although male breast cancer, pancreatic cancer, prostate cancer, and melanoma are associated with BRCA1/2 mutations, discussion of these types of cancer is outside the scope of this recommendation. Accuracy of Familial Risk Assessment The USPSTF reviewed

2019 U.S. Preventive Services Task Force

80. Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: consensus recommendations from The North American Menopause Society and The International Society for the Study of Women’s Sexual Health

disease, given that prophylactic oophorectomy decreases the risk of the devel- opment of new breast cancer in women at risk but without cancer and in survivors with mutations. 115 Nevertheless, despitealackofdata,inwomenwhoarelong-termsurvivors ofER-negativediseaseforwhichriskofrecurrenceislowand symptomatology is troubling, consideration of local HT is reasonable. Women with metastatic disease Women with metastatic breast cancer are a diverse group with significant heterogeneity in prognosis (...) breast cancer risk in carriers of the BRCA1orBRCA2mutationwithintactbreasts,afindingcon- cordant with a systematic review. 114 However, risk-reducing CONSENSUS RECOMMENDATIONS Menopause, Vol. 25, No. 6, 2018 7 Copyright 2018 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.salpingo-oophorectomy in patients with BRCA1 and BRCA2 mutationswasassociatedwithalowerriskofbothdevelopinga first diagnosis of breast cancer and breast cancer-specific mortality

2019 The North American Menopause Society

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