Psychophysical and social impact of risk-reducing salpingo-oophorectomy in China: a cross-sectional study.

Abstract

Objective: Risk-reducing salpingo-oophorectomy has been adopted in China as an effective preventive measure against ovarian cancer, particularly for individuals with breast cancer gene (BRCA) mutations. While the procedure's efficacy in reducing ovarian cancer risk is well established, the associated psychophysical and social impacts have received limited attention. Understanding these impacts is critical for enhancing patient care and improving quality of life.

Methods: This retrospective study included 154 BRCA mutation carriers who underwent risk-reducing salpingo-oophorectomy at Fudan University Shanghai Cancer Center between October 2016 and March 2024. A total of 136 patients were successfully followed up for quality-of-life assessment. Data were collected using the Self-Rating Anxiety Scale, Menopause Rating Scale, Decision Regret Scale, Decision Conflict Scale, and self-reported evaluations. Descriptive statistics were employed to summarize the data, and subgroup analyses were conducted to identify potential influencing factors.

Results: The median age of participants was 46 years. Personal histories of breast cancer were reported in 63.97% (87/136) of the patients, and 8.82% (12/136) were diagnosed with occult ovarian cancer or precancerous lesions post-surgery. Among the cohort, 71.32% (97/136) were postmenopausal. Of the premenopausal patients, only 6 attempted hormone replacement therapy. Anxiety levels and menopausal symptoms were not significantly associated with clinical or demographic variables. Most patients reported low decision regret, with 89.71% (122/136) expressing complete satisfaction with the surgery and only 5.88% (8/136) reporting persistent stress. However, sexual dysfunction was reported by 46.32% (63/136).

Conclusion: Risk-reducing salpingo-oophorectomy is associated with significant challenges, particularly concerning sexual dysfunction. These findings underscore the need for comprehensive preoperative counseling that distinctly addresses biomedical, physiological, and psychosocial considerations, alongside postoperative support to manage the quality-of-life impacts of risk-reducing salpingo-oophorectomy.