"But how will I feel afterwards?": Changes in quality of life from before to after prophylactic oophorectomy among women at risk for breast and ovarian cancer.

A43

Risk-reducing salpingo-oophorectomy (RRSO) performed by age 40 has become the standard of care for women with high risk for ovarian cancer, yet little is known about how RRSO affects a woman's quality of life. The present longitudinal pilot study assessed changes in quality of life from the weeks before surgery to 2 months post surgery among 38 Caucasian women at elevated risk for breast and ovarian cancer. Measures included general health perceptions [SF-1], depression and anxiety (Center for Epidemiological Studies-Depression scale [CESD], State Trait Anxiety Index [STAI], Profile of Mood States [POMS]), perceived risk of breast or ovarian cancer, cancer worry (Cancer Worry Scale [CWS] and Impact of Events Scale [IES]), perceived stress (Perceived Stress Scale), and menopausal symptoms (Menopausal Symptom Scale [BCPT checklist]). The mean age of the participants was 47.6±7.48. The mean educational level was 15.1±2.43 years. Most women were married (89.5%), employed full- (55.3%) or part-(18.4%) time and had children (84.2%). Paired t-test analyses revealed a significant decrease in STAI state (but not trait) anxiety (p < .05), POMS anxiety (p < .01), perceived ovarian (p <. 0001) and breast (p < .001) cancer risk, and cancer worry (CWS p<.001; IES p < .01). There was a significant increase in menopausal symptoms (p < .05), but the mean severity of these symptoms after surgery corresponded to a response between "slightly" and "moderately." In contrast, there was no significant change in general health perceptions, depression, or perceived stress. Interestingly, the decreases in perceived cancer risk were not correlated with decreases in cancer worry or anxiety. Conclusion: RRSO is associated with significant reductions in perceived cancer risk and anxiety but no changes in depression, perceived stress or general health perceptions. Menopausal symptoms did increase but only to a slightly to moderately severe level. These preliminary findings will help surgeons inform patients what to expect emotionally and physically after RRSO.