Box 25.1 Recommended points of information when consenting for risk-reducing gynaecological surgery
Premenopausal women only
- ? Surgery results in infertility and premature menopause
- ? HRT is advised until age of natural menopause unless there is a personal history of breast cancer
- ? General surgical risks (anaesthetic risks, bleeding, blood transfusion, infection, organ injury, thrombo-embolic disease)
- ? Possibility of conversion to open surgery or re-operation in the event of complications
- ? Risk of subsequent peritoneal cancer and other cancers which surgery cannot prevent
- ? Risk of finding occult cancer and/or the need for a second staging operation
achieve via the vaginal route. Peritoneal washings at the time of surgery are mandatory, as they can affect the staging of any occult FTC/OC, and could indicate the presence of occult PPC (Manchanda et al., 2012a).
Box 25.1 summarises points to raise and discuss with women prior to consenting for risk-reducing surgery.
Screening for familial gynaecological cancers
This is discussed in Chapter 20. Screening cannot currently be recommended as a safe alternative to RRSO nor RR-THBSO in BRCA mutation carriers (Rosenthal et al., 2013) and LS (Manchanda et al., 2012b), respectively.