Hormone replacement therapy after risk reducing salpingo-oophorectomy in patients with BRCA1 or BRCA2 mutations; a systematic review of risks and benefits.

@article{Gordhandas2019HormoneRT,
  title={Hormone replacement therapy after risk reducing salpingo-oophorectomy in patients with BRCA1 or BRCA2 mutations; a systematic review of risks and benefits.},
  author={Sushmita B Gordhandas and Barbara M Norquist and Kathryn P. Pennington and Rachel L. Yung and Mary B. Laya and Elizabeth M. Swisher},
  journal={Gynecologic oncology},
  year={2019},
  volume={153 1},
  pages={
          192-200
        }
}
Women with germline BRCA1 or BRCA2 (BRCA) mutations, are recommended risk-reducing salpingo-oophorectomy (RRSO) prior to menopause. Surgical menopause has significant impact on patients' health and well-being. Subsequently, concerns about surgical menopause influence uptake of RRSO in high risk women. The role of hormone replacement therapy (HRT) in BRCA mutation carriers undergoing RRSO has been controversial. In the general population, premature surgical menopause is associated with worse… 
Breast cancer risk and hormone replacement therapy among BRCA carriers after risk-reducing salpingo-oophorectomy.
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Short-term post-RRSO HRT use was associated with a threefold risk of BC in carriers older than 45 years, suggesting that risk may be related to time of exposure to HRT around the natural age of menopause, even among BRCA1/2 carriers.
Hormone therapy after risk-reducing surgery in patients with BRCA1/BRCA2 mutation: evaluation of potential benefits and safety.
TLDR
The current evidence regarding the potential benefits and safety of HRT after RRSO is reviewed and the potential hormonal stimulation of these tumors and the risk of breast cancer are a concern.
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TLDR
Clinician and patient awareness may lead to better utilization of HT in women who undergo oophorectomy at an early age to help mitigate the adverse effects associated with surgical menopause.
Menopausal hormone therapy for BRCA-mutation carriers: attitudes of Israeli healthcare providers before and after a brief educational intervention.
TLDR
In Israel, it is acceptable to offer HT post-RRBSO to healthy BRCA-mutation carriers, and younger healthcare workers and nurses tend to be more hesitant, yet they are more likely to adopt a pro-HT attitude after an educational intervention.
Risk-reducing salpingo-oophorectomy and breast cancer incidence among Jewish BRCA1/BRCA2-mutation carriers - an Israeli matched pair study.
  • T. Perri, G. Levin, +4 authors J. Korach
  • Medicine
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
  • 2021
TLDR
RRBSO is associated with breast cancer risk reduction in Jewish Israeli BRCA2 PSV-carriers and was associated with a decreased overall breast cancer incidence after 5, 10,15 and 20 years.
Menopausal hormone therapy and breast cancer risk.
TLDR
In peri- and postmenopausal women with menopausal symptoms and/or risk factors for osteoporosis in need of MHT, the individual breast cancer risk can be evaluated using internet-based calculators and MHT is a safe option.
Is hormonal therapy after risk-reducing salpingo-oophorectomy associated with an increased risk of malignancy in pathogenic variant carriers?
TLDR
In this multi-institution retrospective study of data from patients with high-risk variant carriers who underwent risk-reducing salpingo-oophorectomy, there was no statistically significant difference in the incidence of malignancy between women who did and did not receive hormone replacement therapy.
Hormone replacement therapy in BRCA mutation carriers and risk of ovarian, endometrial, and breast cancer: a systematic review
TLDR
Although data are limited, HRT does not seem to have a relevant effect on cancer risk in BRCA mutation carriers, and RRBSO should not be postponed to avoid subsequent HRT in this population.
Management of menopausal symptoms and ovarian function preservation in women with gynecological cancer
TLDR
Current, comprehensive guidance for the use of menopausal hormone replacement therapy in women who have had, or are at risk of developing, gynecological cancer is provided to assist with these treatment decisions.
BRCA Genetic Test and Risk-Reducing Salpingo-Oophorectomy for Hereditary Breast and Ovarian Cancer: State-of-the-Art
TLDR
The current situation and problems in doing BRCA genetic test and RRSO are discussed and salpingectomy alone is said to not decrease the risk of developing ovarian or breast cancer, so further discussion is evidently required.
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References

SHOWING 1-10 OF 60 REFERENCES
Effect of short-term hormone replacement therapy on breast cancer risk reduction after bilateral prophylactic oophorectomy in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group.
  • T. Rebbeck, T. Friebel, +16 authors B. Weber
  • Medicine, Mathematics
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2005
TLDR
Short-term HRT use does not negate the protective effect of BPO on subsequent breast cancer risk in BRCA1/2 mutation carriers, and HRT of any type after BPO did not significantly alter the reduction in breast cancerrisk associated with BPO.
Use of total abdominal hysterectomy and hormone replacement therapy in BRCA1 and BRCA2 mutation carriers undergoing risk-reducing salpingo-oophorectomy
TLDR
In this single institution study, the majority of BRCA1/2 mutation carriers undergoing RRSO also underwent TAH, and a substantial number took HRT, although this result did not reach statistical significance.
Osteoporosis risk and management in BRCA1 and BRCA2 carriers who undergo risk-reducing salpingo-oophorectomy.
TLDR
Women with BRCA mutations who undergo RRSO have many risk factors for bone loss, and a clear guideline for screening needs to be established to improve detection of post-RRSO bone disease.
Hormone Replacement Therapy After Oophorectomy and Breast Cancer Risk Among BRCA1 Mutation Carriers
TLDR
It is suggested that use of estrogen after oophorectomy does not increase the risk of breast cancer among women with a BRCA1 mutation and should reassure BRCa1 mutation carriers considering preventive surgery that HRT is safe.
Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation.
TLDR
Sporting risk-reducing salpingo-oophorectomy in carriers of BRCA mutations can decrease the risk of breast cancer and BRCa-related gynecologic cancer.
Menopausal symptoms and bone health in women undertaking risk reducing bilateral salpingo-oophorectomy: significant bone health issues in those not taking HRT
TLDR
Women undergoing BRRSPO <50 years should be counselled concerning the risks/benefits of HRT, taking into consideration the benefits on symptoms, bone health and cardiovascular health, and that the risks of breast cancer from oestrogen-only HRT appear to be relatively small.
Hormone replacement therapy after menopause and risk of breast cancer in BRCA1 mutation carriers: a case–control study
TLDR
It is suggested that a short course of HRT should not be contra-indicated for BRCA1 mutation carriers who have undergone menopause and who have no personal history of cancer.
Uterine Cancer After Risk-Reducing Salpingo-oophorectomy Without Hysterectomy in Women With BRCA Mutations.
TLDR
Although the overall risk for uterine cancer after RRSO was not increased, the risk for serous/serous-like endometrial carcinoma was increased in BRCA1+ women.
Bilateral salpingectomy with delayed oophorectomy for ovarian cancer risk reduction: A pilot study in women with BRCA1/2 mutations.
TLDR
BRCA mutation carriers who underwent bilateral salpingectomy had no intraoperative complications, were satisfied with their procedure choice, and had decreased cancer worry and anxiety after the procedure.
Non-cancer endpoints in BRCA1/2 carriers after risk-reducing salpingo-oophorectomy
TLDR
The prevalence of non-cancer endpoints in a cohort of B1/2 mutation carriers is reported and a particularly high rate of osteopenia and osteoporosis is noted in B 1/2 with breast cancer undergoing RRSO prior to 50.
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