Personalized management of patients at risk should ideally involve a multidisciplinary team that includes not only genetic counselors and surgeons, but also women’s health or menopause specialists, knowledgeable psychologists, and primary care providers or obstetrician-gynecologists who are aware of the risks and fears that “previvors” face, as well as common postoperative issues.
Identifying patients at risk for hereditary cancer, understanding current genetic testing modalities and potential results, knowledge about screening and prevention, including the timing of surveillance, preventive medication, and risk-reducing surgeries, understanding limitations and comorbidities associated with these risk management strategies, and long-term psychological support are all important in hereditary cancer management.
Researchers discussed topics such as identifying high-risk patients, universal screening for breast and ovarian cancer, and screening in particular groups. They offered a simpler method for interpreting and conveying genetic testing findings, as well as testing peculiarities such as direct-to-consumer testing. Concerns about breast cancer screening during pregnancy and breastfeeding are raised. A paradigm is presented for the practical care and counseling of women who choose risk-reducing salpingo-oophorectomy, risk-reducing mastectomy, or both. They presented an in-depth examination of issues such as surgery scheduling, fertility preservation, menopausal symptom treatment, and surgical technique. Alternative options for women who wish to postpone bilateral salpingo-oophorectomy are discussed.
Finally, the psychological repercussions of possessing a genetic mutation are discussed, as are the challenges that women confront after undergoing risk-reducing surgery, such as adjustment, sexuality concerns, and cosmesis.
