Who Should Consider a Prophylactic Mastectomy?
- A prophylactic, or preventative, mastectomy is an operation where breast tissue is removed to reduce the risk of developing breast cancer.
- Women with genetic predispositions, like a mutation in the BRCA1 or BRCA2 gene, should talk to their doctors about the risk vs. benefits of the procedure.
- Another option for at-risk women is called high-risk surveillance, which involves frequent testing in the hopes of detecting cancer early if it does develop.
“Risk reducing mastectomies are an operation where we take women at, usually, very high-risk for getting breast cancer … for genetic mutation carriers, who are the ones at the highest risk, there’s unfortunately only one way to actually prevent breast cancer,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, tells SurvivorNet.
Read More A mutation in the BRCA1 or BRCA2 gene can increase a woman’s risk of developing both breast and ovarian cancer. These genes can be passed down through families. If you find out you do have a mutation, it’s important to speak to your doctor about options. “Women who are found to test positive for a genetic mutation really have two options,” Dr. Port explains. “One is what’s called high-risk surveillance, which means we check them every six months or so mammograms, MRIs with the hope that if, God forbid, they develop breast cancer, we pick it up early. But that’s not prevention, that’s early detection. “Early detection is a goal, it’s not a guarantee. For the woman who wants to be more proactive about actually preventing breast cancer, or as we say reducing her risk, unfortunately, the only way to do that is to remove the actual tissue at risk and that is the breast tissue,” she adds.
The benefits of a prophylactic or preventative surgery are:
- Significant reduction in cancer risk (from 80-90% to 1-2%)
- Nipples can often be spared
- Women can get reconstruction at the same time
Of course, there are other aspects to consider, and it’s important to speak with your healthcare provider about your individual risk factors and the benefits of a preventative surgery vs. more of a watch-and-wait approach.
Questions to Ask Your Doctor
- Should I undergo genetic testing to assess my breast cancer risk?
- What are the benefits of a watch & wait approach vs. preventative surgery?
- What should I know about implants should I opt for a preventative surgery?
- What kind of surveillance is required after the surgery?
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