Authors (including presenting author) :
LAM CH, Yung KK, Wong TK, Yim SF, Lee HS, Yeung SY
Affiliation :
Department of Obstetrics & Gynaecology, Prince of Wales Hospital
Introduction :
Women with hereditary cancer syndromes, including hereditary breast and ovarian cancer syndrome (HBOC) and Lynch syndrome (HNPCC), face an increased risk of gynecological malignancies. As awareness of these conditions grows and genetic testing advances, a greater number of women are being identified as high-risk. Many of these individuals experience psychological distress and uncertainty about their preventive care options. Establishing a specialized gynecological clinic, staffed by experienced gynecological oncologists, is essential to provide comprehensive support and management tailored to their needs.
Objectives :
The objective of this clinic is to establish a dedicated platform where women who diagnosed with hereditary cancer syndromes can receive personalized risk assessment, counseling, and access to specialized surgical options. The clinic aims to enhance patient education, improve psychological well-being, and facilitate informed decision-making regarding preventive measures.
Methodology :
Women who diagnosed with various hereditary cancer syndromes with increased risk for gynaecological malignancy are referred to our designated clinic and seen by gynaecological oncologist. Women received individualized counseling focused on understanding their cancer risks. The clinic provides guidance on preventive measures, including prophylactic surgeries and surveillance options for those who choose to decline surgery. A departmental protocol was designed to provide guidance on counseling and surveillance of HBOC and Lynch syndromes.
Result & Outcome :
Since the establishment of the clinic in 2023, there were 46 appointments in NTEC. The attendance rates were 93% (43). This included 31 new cases and 15 old cases. Their mean age was 45 years old; 41% of them are BRCA carriers (22% BRCA-1, 19% BRCA-2), 35% of them are Lynch syndrome (HNPCC) carrier (11), 16% of them (5) have other known hereditary cancer syndrome such as Peutz Jeghers syndrome, etc., the remaining 6% are patients with strong family history of colorectal cancer (2). 10 patients (32%) opted for prophylactic surgeries such as laparoscopic hysterectomy, bilateral salpingo-oophorectomy, while 16 patients (51%) opted for interval surveillance including regular blood tests and imaging investigations. As for the outcome, no suspected or confirmed malignancy is detected from interval surveillance so far, while patients who opted for prophylactic surgery are still pending for their operation.
Conclusion: The establishment of a specialized gynecological clinic for women with hereditary cancer syndromes marked a significant step toward enhancing care for this population. By providing comprehensive counseling on risks and preventive options, this clinic empowered patients to make informed decisions about their health. Future improvements in service can be achieved through ongoing outcome evaluations, including clinical outcome tracking and patient satisfaction assessments, as well as the integration of a multidisciplinary team, including psychological counselors.
