Who is prone to high levels of distress after prophylactic mastectomy and/or salpingo-ovariectomy?

Ann Oncol. 2007 Oct;18(10):1641-5. doi: 10.1093/annonc/mdm274. Epub 2007 Jul 28.

Abstract

Background: The present study aimed to assess predictors of distress after 'prophylactic mastectomy (PM) and salpingo-ovariectomy (PSO), in order to enable the early identification of patients who could benefit from psychological support.

Patients and methods: General distress and cancer-related distress were assessed in 82 women at increased risk of hereditary breast and/or ovarian cancer undergoing PM and/or PSO, before and 6 and 12 months after prophylactic surgery. Neurotic lability and coping were assessed before surgery.

Results: Cancer-related distress and general distress at both follow-up moments were best explained by the level of cancer-related and general distress at baseline. Being a mutation carrier was predictive of increased cancer-related distress at 6-month follow-up (but not at 12 months), and of lower general distress 12 months after prophylactic surgery. Also, coping by having comforting thoughts was predictive of less cancer-related distress at 6-month follow-up.

Conclusions: Genetically predisposed women who are at risk of post-surgical distress can be identified using one or more of the predictors found in this study. Exploration of and/or attention to cancer-related distress and coping style before prophylactic surgery may help physicians and psychosocial workers to identify women who might benefit from additional post-surgical support.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Breast Neoplasms / genetics
  • Breast Neoplasms / prevention & control*
  • Breast Neoplasms / psychology
  • Fallopian Tubes / surgery*
  • Female
  • Genetic Predisposition to Disease / psychology
  • Heterozygote
  • Humans
  • Mastectomy / psychology*
  • Middle Aged
  • Mutation
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / prevention & control*
  • Ovarian Neoplasms / psychology
  • Ovariectomy / psychology*
  • Prospective Studies
  • Stress, Psychological / etiology*