因BRCA基因突變進行降風險手術時的子宮存棄問題

The role of hysterectomy at the time of risk-reducing salpingo-oophorectomy for the BRCA mutation carrier

對有BRCA突變者，常同時建議切除輸卵管卵巢來降低卵巢癌和輸卵管癌。然而在行降風險輸卵管卵巢切除（risk reducing salpingo-oophorectomy, RRSO）時，需要同時切除子宮嗎？此時須考量其利弊得失，如子宮切除的手術風險、增加開銷、補充荷爾蒙包括tamoxifen的潛在風險等缺點；但可能有減少子宮惡性腫瘤之優點，因此在RRSO時如併切除子宮需與患者詳加討論其優劣。

BRCA mutation carries who elect to undergo risk-reducing salpingo-oopho rectomy (RRSO) also face the complex decision of whether or not to undergo removal of the uterus along with the ovaries and tubes. Performing a hysterectomy at the time of RRSO slightly increases surgical risks and short-term morbidity but might provide long-term benefits. While having a BRCA mutation seems appear to increase the risk of uterine serous cancer, tamoxifen induced uterine cancer, women may elect to undergo hysterectomy to eliminate these risk. An individualized discusssion on the benefirs and risks of considering a hysterectomy at the time of the RRSO is prudent.