Preventive Mastectomy

Preventive mastectomy, also known as prophylactic mastectomy, is a surgery that women undergo to remove one (unilateral mastectomy) or both (bilateral mastectomy) of the breasts to reduce the risk of developing breast cancer in future. A strong family history of breast cancer or the presence of certain genetic mutations presents a high risk of breast cancer.

Women at high-risk can reduce the chances of developing breast cancer by 90% through this surgery. In some cases, lumpectomy (removing a lump from the breast) will be all that is required, rather than removing the whole breast.

When to consider Preventive Mastectomy?

It is better to go for the prophylactic breast removal  if:

• Family history of breast cancer: If your grandmother, mother, sister or other close blood relative had breast cancer, especially if they were diagnosed before the age 50, you may be at increased risk. The risk is even higher if anyone had a breast cancer from the mother or father side.
• Positive results in genetic testing: Genetic testing can identify mutations in genes that can significantly increase your risk of breast cancers. Consider gene testing if family history of breast cancer is found. The first stage of genetic testing looks at DNA of a relative who has breast cancer or had breast cancer. If the test of the relative is positive, predictive or mutation testing is offered.
• Undergone radiation therapy: If you had radiation therapy to your chest before the age of 30, you may be at increased risk of developing breast cancer.
• Dense breast: If your doctor finds a cluster of micro-calcifications (small deposits of calcium in the breast), then there is a possibility of breast cancer. Also, dense breast makes it difficult for doctors to diagnose breast cancer. It requires the removal of tissue samples to study under a microscope.
• Cancer in one breast: You may decide to have the other, unaffected breast removed if you had breast cancer in one breast or have a very strong family history of the same.

Is Preventive Breast Surgery Effective?

Preventive mastectomy drastically reduces the risk of cancer in women up to 90% but can never completely eliminate the risk of breast cancer. The operation aims to remove all breast tissue that could develop breast cancer. Prophylactic breast surgery may also be considered if a woman has had breast cancer and is therefore at increased risk of developing the disease again in the other breast.

What are the risks involved in Prophylactic Mastectomy?

• Increased risk of infection in the surgical area
• Swelling (lymphedema) in your arm
• Blood build up under the surgical site
• Extra sensitivity to touch
• Numbness of the skin
• Hard scar tissue formation
• Shoulder pain and stiffness

Making the decision whether to have preventive mastectomy surgery is not urgent. You must weigh all pros and cons along with its effect on your life and daily routine. Your breast-health specialist and psychologist will help you make better choices. Before surgery, it is advised to consult your surgeon and discuss surgery options, review medical history and determine the best possible plan. This is a good time to ask questions and to make sure you understand the procedure, including the reasons, benefits, and risks of the preventive breast surgery.

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