Whether or not to have a prophylactic mastectomy is a difficult decision to make, given the psychological and physical effects the operation may have on an individual and the irreversible nature of the procedure.
It is, however, an option that high-risk groups may want to consider, but only after proper risk assessment, counseling, and the consideration of other options such as chemoprevention and close surveillance, which includes monthly self-examinations, clinical breast examinations, and regular mammograms.
Prophylactic mastectomy refers to the process of surgically removing one breast or even both breasts before the appearance of cancer.
It may be performed for women who belong in high risks groups, such as those who have a strong family or personal history of breast cancer or who have lobular carcinoma in-situ.
The highest risk, however, is borne by women who have the BRCA1 and BRCA2 gene mutations, their estimated lifetime risk of developing breast cancer being 56% to 85%, compared to the general average of between 5% and 8%.
Women with BRCA1 and BRCA2 also tend to develop breast cancer earlier than women who do not carry these genes.
The risk of breast cancer among women who exhibit no symptoms of the disease may be reduced by 80% to 90% by bilateral prophylactic mastectomies, based on retrospective reviews.
Patients should be aware, however, that while having a prophylactic mastectomy may reduce the risk of breast cancer, that risk still remains because it is simply not possible to remove all breast tissue.
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