Prophylactic Mastectomy for Patients with High Risk of Breast Cancer

Breast Reconstruction

Prophylactic Mastectomy

Prophylactic mastectomy is a good option for patients who are at high risk of developing breast cancer. In certain situations, prophylactic mastectomy can reduce the risk of developing breast cancer by 90%-95%.

Now vs Later

If Any Of The Following Apply To You, You Are A Candidate For Prophylactic Mastectomy:

a positive test for a genetic mutation that predisposes to breast cancer (eg BRCA1, BRCA2, PALB2, CDH1, PTEN, or TP53)
several family members who developed breast cancer (including mother, sister, or daughter), especially before age 50
a particularly aggressive or invasive breast cancer
high risk histology on biopsy (eg “invasive lobular” disease or “lobular carcinoma in situ”)
multiple tumors in the same breast
very young age at the time of the first breast cancer diagnosis
chest radiation before age 30

In patients undergoing mastectomy for breast cancer, prophylactic mastectomy of the other breast can be performed at the same time, or any time later. The best timing for the prophylactic surgery depends on the patient’s clinical situation, overall treatment plan and preferences.

In patients who do not have an existing breast cancer diagnosis but are at high risk, prophylactic mastectomy of both breasts is always performed at the same time.Nipple Sparing Mastectomy which preserves the entire breast skin envelope and natural nipple-areola is also frequently an option and should be discussed with your plastic surgeon.For patients choosing to have breast reconstruction, the best cosmetic results are achieved when the reconstruction is performed at the same time as the mastectomies (“immediate reconstruction”). Several breast reconstruction options can be performed in conjunction with prophylactic mastectomy including: