Preventive (prophylactic) mastectomy is a method to reduce breast cancer risk. Unlike mastectomy, preventive mastectomy is performed without breast cancer diagnosis – which requires treatment. It is in this case when a healthy woman decides to proceed to preventive mastectomy on breast cancer high-risk assessment due to specific medical factors.
Preventive mastectomy is a powerful preventive means, as it can reduce chance of developing cancer by up to 95% but cannot guarantee elimination of breast cancer risk.
Breast cancer risk factors
Women in breast cancer high-risk group are recommended to have preventive mastectomy on exhibiting one or more of the following factors:
- Genetic tests assessed gene mutations increasing cancer risk, such as in BRCA1, BRCA2 and PALB genes. Women with such mutations are also at increased risk for ovarian cancer, leading them to decide having a preventive hysterectomy.
- Family history of breast cancer in more than one close relative (mother, grandmother, daughter or sister), especially if cancer occurred under 50 years of age.
- Recovered from breast cancer or previously diagnosed with lobular in situ carcinoma (LCIS).
- Breast radiotherapy under 30 years of age.
- Dense breasts with a low fat percentage and a high gland percentage and sclerosing adenosis with multiple microcalcifications, resulting in suspicious clinical picture of mammography.
Preventive mastectomy techniques
Depending on the general health picture, the subject’s medical history and the anatomic characteristics of each breast, preventive mastectomy can be performed applying 3 different techniques:
- Total mastectomy, in which the whole breast is removed along with the nipple and areola.
- Skin-sparing mastectomy, in which all breast tissue, nipple and areola is removed, but skin is retained.
- Nipple-sparing mastectomy, in which all breast tissue is removed, but skin, nipple and areola are retained.
In all cases, along with preventive mastectomy, breast implant surgery can be performed to avoid any negative psychological effects due to breast loss.
Anesthesia
Preventive mastectomy is performed under general anesthesia – the method being selected by the physician and the anesthesiologist, aiming at subject comfort and safety during the operation.
Postoperatively
Depending on the technique applied, the subject can be hospitalized for 24-48 hours. For the first few days, a very good sports bra is recommended and the precautionary antibiotic treatment is always prescribed, taking into account the subject’s medical history.
Results and Recovery
Preventive mastectomy results usually take several weeks to a few months to become evident depending on the technique applied and the combination of a recovery surgery. Scars are evident in the first 3 months but progressively they fade out significantly.
Cost
Preventive mastectomy cost depends on the techniques applied, the combination of a recovery surgery and the subject’s general health. Furthermore, the cost of hospitalization, any pre- or postoperative medical tests required and medication should be taken into account as well.
