Table I.
RRS for HBOC and Lynch syndrome.
| Postoperative considerations | HBOC | Lynch syndrome |
|---|---|---|
| Surgical complications | Infection | Ureteral injury |
| Perforation of the bladder | Ureterovaginal fistula | |
| Distal obstruction of the small bowel | Ureteroenteral fistula | |
| Perforation of the uterus | ||
| Treatment of ovarian deficiency symptoms | 20 mg/day bazedoxifene + 0.625 mg/day conjugated estrogen, as HRT reduces the risk of breast cancer conjugated and endometrial cancer. In cases with breast cancer, an SSRI or SNRI is initiated. | 20 mg/day bazedoxifene + 0.625 mg/day estrogen, as HRT reduces risk of breast and endometrial cancers |
| Postoperative management | No consensus | No information. As follow-up for Lynch syndrome with or without RRS, the following are recommended: |
| Bone densitometry | ||
| Annual measurement of serum CA125 level | Lower gastrointestinal endoscopy every 1–2 years and removal of precancerous polyps | |
| Annual internal examination | Annual cytology and histological examination of the endometrium, transvaginal ultrasound and serum CA125 level measurements | |
| Any of the above may be combined | Routine urinalysis with cytology | |
| Postoperative occurrence of tumors | Breast cancer | No information |
| Ovarian cancer | ||
| Fallopian tube cancer | ||
| Primary peritoneal cancer |
HBOC, hereditary breast and ovarian cancer; HRT, hormone replacement therapy; SSRI, selective serotonin reuptake inhibitor; SNRI, serotonin noradrenalin e reuptake inhibitor; RRS, risk-reducing surgery.