Our Summary

This study looks at the cost-effectiveness of preventative surgeries for individuals with a high genetic risk of developing cancer, specifically in Germany. Such surgeries include bilateral risk-reducing mastectomy (removal of both breasts), with or without breast reconstruction, and risk-reducing salpingo-oophorectomy (removal of ovaries and fallopian tubes).

The researchers found that, while some procedures still resulted in a small profit for hospitals, others actually led to financial losses. The biggest losses were found in cases of breast removal with implant-based reconstruction, and when multiple risk-reducing procedures were combined into fewer operations.

The study concludes that these preventative surgeries often do not cover their own costs in the German healthcare system, and that new approaches are needed to ensure these surgeries can be provided on a nationwide scale.

FAQs

  1. What are the types of preventative surgeries discussed in the study for individuals with a high genetic risk of cancer?
  2. What were the financial implications for hospitals performing these risk-reducing surgeries, according to the study?
  3. What was the conclusion of the study regarding the cost-effectiveness of these preventative surgeries in the German healthcare system?

Doctor’s Tip

A doctor might tell a patient considering a salpingo-oophorectomy that while the surgery can reduce the risk of developing ovarian and fallopian tube cancer, it is important to weigh the potential benefits against the potential risks and side effects. They may also discuss alternative options for reducing cancer risk and provide information on post-operative care and follow-up.

Suitable For

Patients who are typically recommended salpingo-oophorectomy include those with a high genetic risk of developing ovarian and/or breast cancer. This includes individuals with mutations in the BRCA1 or BRCA2 genes, as well as those with a strong family history of these cancers. Salpingo-oophorectomy may also be recommended for individuals with a personal history of breast cancer, as it can reduce the risk of developing a second primary cancer in the ovaries.

Additionally, salpingo-oophorectomy may be recommended for individuals who have completed childbearing and are at a high risk of developing ovarian cancer, as the procedure can significantly reduce the risk of developing this type of cancer. It may also be considered for individuals with certain types of benign ovarian tumors or cysts that are at risk of becoming cancerous.

Overall, the decision to recommend salpingo-oophorectomy is typically made on a case-by-case basis, taking into account the individual’s personal and family medical history, genetic risk factors, and overall health status.

Timeline

Before Salpingo-Oophorectomy:

  1. Patient undergoes genetic testing to determine their risk of developing cancer.
  2. Patient consults with a genetic counselor to discuss their options for preventative surgeries.
  3. Patient decides to undergo salpingo-oophorectomy as a risk-reducing measure.
  4. Patient meets with a surgeon to discuss the procedure and its potential risks and benefits.
  5. Patient undergoes pre-operative testing and preparations for surgery.

After Salpingo-Oophorectomy:

  1. Patient undergoes the salpingo-oophorectomy procedure.
  2. Patient stays in the hospital for a period of time for recovery.
  3. Patient may experience side effects such as pain, fatigue, and hormonal changes.
  4. Patient may need to take hormone replacement therapy to manage menopausal symptoms.
  5. Patient follows up with their surgeon and oncologist for post-operative care and monitoring.
  6. Patient may undergo genetic counseling and testing for further cancer risk assessment.
  7. Patient may experience emotional and psychological impacts of the surgery, such as anxiety and fear of cancer recurrence.
  8. Patient may need to make lifestyle changes to reduce their risk of cancer, such as maintaining a healthy diet and exercise routine.

Overall, the patient’s experience before and after salpingo-oophorectomy involves a combination of medical, emotional, and lifestyle factors that require ongoing care and support.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a salpingo-oophorectomy?

  2. How will the removal of my ovaries and fallopian tubes affect my hormone levels and menopausal symptoms?

  3. Will I need to take hormone replacement therapy after the surgery?

  4. How will a salpingo-oophorectomy impact my fertility and options for future pregnancy?

  5. What is the recommended follow-up care and monitoring after the surgery?

  6. Are there any alternative risk-reducing options to consider before undergoing a salpingo-oophorectomy?

  7. How will the surgery impact my risk of developing cancer in the future?

  8. How long is the recovery period after a salpingo-oophorectomy?

  9. Will my insurance cover the cost of the surgery and any associated treatments or medications?

  10. Are there any lifestyle changes or precautions I should take after the surgery to optimize my health and well-being?

Reference

Authors: Schrauder MG, Brunel-Geuder L, Häberle L, Wunderle M, Hoyer J, Csorba R, Reis A, Schulz-Wendtland R, Beckmann MW, Lux MP. Journal: Eur J Med Res. 2019 Sep 14;24(1):32. doi: 10.1186/s40001-019-0391-8. PMID: 31521205