Preventive Mastectomies
A preventive mastectomy means that a woman chooses to have her breasts surgically removed in order to prevent the development of breast cancer in the future. It is reserved for women who are at a very high risk of developing breast cancer in their lifetime.
The process starts with a consultation with our breast surgeon that covers a woman's risk factors for breast cancer, such as family history of breast or ovarian cancers, her personal history of abnormal breast biopsies as well as a thorough breast exam. She may undergo genetic testing to see if she is a carrier of a harmful genetic mutation, such as the BRCA1 or BRCA2 gene, and will also consult with a plastic surgeon to discuss breast reconstructive options.
During the mastectomy surgery all of the breast tissue is removed, and the skin is left intact for the reconstruction of the new breast and implant. Generally, patients spend one night in the hospital after the surgery and recovery takes four to six weeks. Most women do very well and, after reconstruction, are extremely happy with their cosmetic result. They can do everything they could before surgery - wear a bikini, exercise and be there for their family - not to mention the peace of mind that comes with significantly decreasing their risk of breast cancer.
How effective is the surgery in preventing breast cancer?
Preventive mastectomy is extremely effective in preventing breast cancer in high risk women and can decrease their risk of developing it by 90-95 percent. It is the greatest breast cancer risk-reductive strategy that we have.
What about alternatives?
Alternatives to preventive mastectomy include high-risk screening which usually means a woman undergoes a clinical breast exam by her doctor every six months along with screening mammography and breast MRI on a prescribed schedule. They may also be encouraged to take Tamoxifen, a medication that can decrease the risk of developing breast cancer by 50 percent when taken daily for five years.
Women who are at high-risk of developing breast cancer are encouraged to be followed by a breast surgeon and to regularly perform self-exams, getting to know their breasts and reporting any changes to their doctor.