Psychological quality of life in BRCA1/2- carriers following risk-reducing salpingo-oophorectomy: a preliminary report.

Objective: The psychological consequences following risk-reducing salpingo-oophorectomy (RRSO) have not been clarified. Our objective was to investigate general well-being and symptoms of anxiety and depression before and 1 year after RRSO in BRCA1/2- pathogenic variant carriers, versus comparators and to study if testosterone levels after RRSO correlate with psychological well-being and vitality.

Methods: In this observational follow-up study, 43 BRCA1/2-carriers planned for RRSO and 73 age-matched comparators were evaluated using the Hospital Anxiety and Depression Scale (HADS) and Psychological General Well-being Index (PGWBI) before and one year after surgery or at inclusion (comparators). Blood samples for analysis of testosterone by tandem mass spectrometry were also collected, and free androgen index (FAI) was calculated.

Results: In the RRSO group, 53.5% reported elevated anxiety levels at baseline that decreased to 32.6% at follow-up (P=0.029). However, at 1 year, the RRSO group still reported higher anxiety levels versus the comparator group (16.4%, P=0.038). The RRSO group reported low and stable levels on the depression scale, and no change was found in well-being, but significantly worse scores of the PGWBI dimensions depressed mood and general health at follow-up as opposed to comparators (80.0 vs. 86.7, P=0.04; 80.0 vs. 86.7, P=0.028). FAI was significantly lower in the RRSO group versus comparators at 1-year follow-up (0.6 vs. 0.9, P=0.041). Testosterone levels were not correlated with either well-being or vitality.

Conclusions: Our data identified no negative effect on psychological quality of life 1 year following RRSO. Larger studies are needed to confirm these preliminary findings.