Prophylactic options compared for women with BRCA1/2December 27, 2012 in Medicine & Health / Obstetrics & gynaecology
(HealthDay)—The results of a simulation model suggest that, when quality of life is considered, prophylactic bilateral salpingectomy with delayed oophorectomy may be an acceptable alternative to bilateral salpingo-oophorectomy for women with BRCA mutations, according to research published in the January issue of Obstetrics & Gynecology.
Janice S. Kwon, M.D., of the University of British Columbia and the BC Cancer Agency in Vancouver, Canada, and colleagues developed a Markov Monte Carlo simulation model to compare the risk reduction for women with BRCA mutations for three strategies: bilateral salpingo-oophorectomy, bilateral salpingectomy, or a bilateral salpingectomy with delayed oophorectomy.
The researchers found that, compared with the other strategies, bilateral salpingo-oophorectomy correlated with the lowest cost and highest life expectancy, and with the lowest number of future breast and ovarian cancers. After inclusion of quality-of-life parameters, the highest quality-adjusted life expectancy was seen for salpingectomy followed by delayed oophorectomy, with incremental cost-effectiveness ratios of $37,805 per quality-adjusted life-year for BRCA1 and $89,680 per quality-adjusted life-year for BRCA2, relative to salpingectomy alone.
"Although it remains to be validated prospectively, bilateral salpingectomy with delayed oophorectomy may be a reasonable alternative to bilateral salpingo-oophorectomy, especially for those who are reluctant to undergo the latter procedure because of the potential effect on quality of life," Kwon and colleagues conclude.
Editorial (subscription or payment may be required)
Copyright © 2012 HealthDay. All rights reserved.
"Prophylactic options compared for women with BRCA1/2" December 27, 2012 https://medicalxpress.com/news/2012-12-prophylactic-options-women-brca12.html