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

All women

  • ? 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.

 
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