Breast Cancer and Preventive Mastectomy
Who Should Have a Preventive Mastectomy?
According to the Society of Surgical Oncology, only those women who are at very high risk of breast cancer should consider preventive mastectomy. This includes women with one or more of the following risk factors:
- Mutated BRCA genes
- Previous cancer in one breast and a strong family history of breast cancer
- History of lobular carcinoma in situ (LCIS)
Preventive mastectomy should only be considered after you've received the appropriate genetic and psychological counseling to discuss the psychosocial impacts of the procedure.
What Are My Options for Breast Cancer Surgery?
For women who choose prophylactic mastectomy, several new and important surgical options have become available.
It is now possible to remove breast tissue using skin-sparing techniques in which the underlying breast tissue is removed from just under the skin, down to the chest wall. This technique removes the vast majority of the glands where breast cancer may be likely to develop. The nipple and surrounding tissue, called the areola, are removed, because the ducts converge toward the nipple, creating a concentrated area of duct tissue. However, the skin of the breast is spared, preserving the breast skin envelope.
When skin-sparing mastectomy is combined with immediate breast reconstruction, the results can be excellent. Women who choose prophylactic mastectomy, often combined with immediate reconstruction, are very pleased, not only with their choice but also the reconstruction.
While surgery is not an approach that should be advocated for all high-risk individuals, it can be very important for some women.