“SHOULD RISK-REDUCING GYNECOLOGIC SURGERY FOR BRCA MUTATION CARRIERS INCLUDE HYSTERECTOMY?”
ANDREW M. KAUNITZ, MD (WEB EXCLUSIVE, AUGUST 28, 2016)
Hysterectomy warranted?
I am wondering if Dr. Kaunitz really is recommending performing 270 hysterectomies to prevent one endometrial cancer? Is this justified given the risks from the hysterectomy itself, the economics of the disease, or any significant reductions in endometrial cancer mortality?
David O. Holtz, MD
Paoli, Pennsylvania
Dr. Kaunitz responds
I appreciate Dr. Holtz’s interest in my commentary on the role of hysterectomy as part of risk-reducing surgery in BRCA mutation carriers. Women who are mutation carriers are at increased risk for serous or serous-like endometrial cancers. Further, hysterectomy offers specific advantages for young mutation carriers for whom menopausal hormone therapy is often indicated after risk-reducing salpingo-oophorectomy. Accordingly, I would indeed encourage such women to consider hysterectomy as part of risk-reducing gynecologic surgery if such surgery can be accomplished via minimally invasive techniques.
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