Preventative mastectomy is the removal of one or both breasts in order to reduce the risk of developing breast cancer. This decision should only be considered after you have received the proper psychological and genetic counseling and discussed, not only the physical, but also the psychosocial impacts you can experience after the procedure. Preventative mastectomies are considered under the following circumstances:
• As a way to reduce the risk of a recurrence in women who have already been diagnosed with breast cancer
• When the gene mutations BRCA1, BRCA2, PALB2, CDH1, PTEN or TP53 are present – all of these mutations increase the risk of breast cancer.
• When you have a prominent history of breast cancer in your family
• If you have atypical lobular hyperplasia, which is a condition where there are irregular cells lining the milk lobes
• If LCIS (lobular carcinoma in situ) is present, which is a noninvasive breast cancer that increases your risk of developing invasive breast cancer
• If you have received radiation therapy before the age of 30, which will increase the risk of breast cancer throughout your life.
Studies have shown that 4-6% of women who had a mastectomy in the late 1990’s decided to have the other healthy breast removed. Research published in 2016 showed the rates of prophylactic mastectomy more than tripled from 2002-2012, even though other studies revealed that in the same time removing the healthy breast didn’t improve survival. Research recently done suggests that up to 25% of newly diagnosed breast cancer patients go through with a contralateral prophylactic mastectomy. Although it may reduce the risk of developing breast cancer by 90%, it doesn’t guarantee that breast cancer will not develop, because it just isn’t possible to remove 100% of breast tissue.
The Society of Surgical Oncology recommends preventative mastectomy should be only considered in women who have a very high risk of developing breast cancer. This includes women who possess one or more of the following risks:
• Previous cancer in one breast
• Strong family history of breast cancer
• Mutated BRCA genes
• History of LCIS
Considering a preventative mastectomy is something that should not be taken lightly. It may be the best choice, but make sure that you are fully prepared and have thought out and looked at every option. Take care of yourself first and do what’s right for you.