Prophylactic / Preventative Mastectomy
Prophylactic / Preventative Mastectomy
What is a Prophylactic/Preventative Mastectomy?
This type of mastectomy is performed on individuals who do not yet have breast cancer. It involves removing one or both breasts as a way to reduce the risk of developing the disease. The decision to have prophylactic mastectomy is often made by women who have a high genetic risk of developing breast cancer, such as those with a BRCA1 or BRCA2 gene mutation.
There are two main types of prophylactic mastectomy, which may also be done with or without breast reconstruction at the same time:
- Bilateral prophylactic mastectomy, [Link to Bilateral Mastectomy] where both breasts are removed
- Unilateral or contralateral prophylactic mastectomy, [Link to Unilateral Mastectomy] where only one breast is removed
In addition, you may opt for a total mastectomy [Link to Total Mastectomy] (removal of the entire breast), skin-sparing mastectomy [Link to Skin-Sparing Mastectomy] (removal of breast tissue but preservation of skin), and nipple-sparing mastectomy [Link to Nipple-Sparing Mastectomy (removal of breast tissue but preservation of nipple).
While this procedure significantly reduces the risk of developing breast cancer, it does not completely eliminate the possibility. It is important for women considering prophylactic mastectomy to weigh the potential benefits against the risks and potential complications associated with surgery.
If you are a woman with a high risk of developing breast cancer, you should discuss your options with their doctor and a genetic counselor to determine if prophylactic mastectomy is the right choice for you based on your personal and family medical history.
You should also keep in mind that ongoing surveillance and monitoring may still be necessary even after undergoing this surgery. Overall, prophylactic mastectomy can be an effective option for reducing the risk of breast cancer in high-risk individuals, but it's crucial to make an informed decision after thorough consideration and discussions with healthcare professionals.
What are the Benefits of a Prophylactic/Preventative Mastectomy?
A prophylactic/preventative mastectomy is a surgical procedure in which one or both breasts are removed to reduce the risk of developing breast cancer. While this decision is a highly personal one and should be carefully considered with the guidance of medical professionals, there are several potential benefits to undergoing this preventive surgery.
- Reduced Risk of Breast Cancer: The most obvious benefit of a prophylactic mastectomy is a significantly reduced risk of developing breast cancer. In fact, the American Cancer Society says that it can lower the risk of breast cancer by 90% or more. For women who have a strong family history of breast cancer or carry certain genetic mutations such as the BRCA gene, this surgery can greatly decrease their chances of being diagnosed with the disease.
- Peace of Mind: Knowing that you have taken proactive steps to lower your risk of breast cancer can provide peace of mind and lessen anxiety about the possibility of developing the disease in the future. This may also lessen the number of required screenings and monitoring, which can be emotionally taxing for some individuals.
- Avoids Potential Need for Chemotherapy/Radiation: If breast cancer does develop in someone who has undergone a prophylactic mastectomy, it may be detected at an earlier stage when treatment options are more effective and less invasive. This could potentially avoid the need for chemotherapy or radiation therapy, which can have significant side effects on physical and emotional well-being.
- Improved Cosmetic Outcome: Advances in reconstructive surgery techniques have made it possible for many women who undergo a prophylactic mastectomy to achieve aesthetically pleasing results that closely resemble natural breasts. This can help boost self-esteem and body image following the surgery.
- Empowerment: By choosing to undergo a prophylactic mastectomy, individuals take control over their health outcomes and empower themselves to make decisions that prioritize their well-being and longevity. This sense of agency can lead to increased confidence and overall satisfaction with your health choices.
Who is a Good Candidate for a Prophylactic/Preventative Mastectomy?
Mastectomy is a serious surgery, and while deciding to have one at a preventative measure is not necessary for everyone, there are certain individuals who may be considered good candidates for a prophylactic mastectomy. Here are some factors that may make someone a good candidate for this type of surgery:
- High Genetic Risk: Women with certain genetic mutations, such as BRCA1 or BRCA2, have a significantly increased risk of developing breast cancer. Women with these mutations may opt for a prophylactic mastectomy to greatly reduce their risk of developing the disease.
- History of Breast Cancer: If someone has already had breast cancer in one breast, they may choose to have a prophylactic mastectomy on the other breast to prevent the cancer from recurring. Family History: A strong family history of breast cancer, especially at a young age, can increase an individual's risk of developing the disease. In these cases, a prophylactic mastectomy may be recommended as a preventive measure.
- Previous Radiation Therapy: Individuals who have received radiation therapy to the chest area before the age of 30 are at an increased risk of developing breast cancer later in life and may consider a prophylactic mastectomy to mitigate this risk.
It is important to note that undergoing a prophylactic mastectomy is not an easy decision and should be carefully considered after consulting with doctors and genetic counselors. It's also essential for individuals considering this procedure to understand all potential risks and benefits before making their decision. Ultimately, each person's situation is unique, and it is crucial to weigh all factors carefully when determining if you are a good candidate for a prophylactic/preventative mastectomy.
What Should I Expect From My Surgery?
During a prophylactic mastectomy, the surgeon removes all of the breast tissue, including the ducts and lobules where cancer usually begins. In some cases, nipple-sparing or skin-sparing mastectomies may be performed to preserve some of the natural tissue. After surgery, patients may choose to undergo breast reconstruction [Link to Breast Reconstruction] to restore the appearance of their breasts. This can be done using implants or autologous tissue (flap) reconstruction.
Before Surgery
Before your surgery, you'll have a meeting with your surgical team to go over the details of your operation. This is a great opportunity to ask any questions you may have and ensure you fully understand the procedure, its purpose, associated risks, and any alternative treatments available.
Your healthcare team will provide you with specific instructions to prepare for surgery, which may include:
- Informing your healthcare team about any medications, vitamins, or supplements you're currently taking, as certain substances may interfere with the surgery.
- Stopping certain medications, such as aspirin or other blood-thinners, as advised by your healthcare team.
- Following guidelines regarding fasting before surgery, which may involve refraining from eating for several hours beforehand and only drinking liquids up to a certain time.
- Planning for post-surgery arrangements, such as whether you'll need to stay in the hospital overnight or go home the same day. Arrange for transportation if you're discharged the same day and prepare a bag with essentials for your hospital stay, including toiletries and items for comfort and entertainment.
During Surgery (Procedure Overview)
A mastectomy will normally involve staying in the hospital for at least one night, depending on the type of surgery you will be having. The procedure can vary based on your personal circumstances and your doctor's methods.
- You'll be asked to change into a gown.
- An IV (intravenous) line will be inserted into your arm or hand to give you medication that will help you relax and put you to sleep during surgery.
- You'll lie on your back on the operating table.
- Your vital signs, like heart rate and blood pressure, will be monitored throughout the surgery.
- The skin around the surgical area will be cleaned with a sterile solution and an incision will be made in your breast.
- The breast tissue will be carefully removed, either including the nipple and skin or retaining them. The lymph nodes are normally left intact in a prophylactic mastectomy unless your surgeon is concerned about them.
- If you're having breast reconstruction at the same time, a plastic surgeon will perform the procedure after the mastectomy. If your skin is removed, the reconstruction may be made with a flap of your own tissue removed from elsewhere in your body or with a tissue expander used to stretch the skin in preparation for a further reconstruction operation later.
- If your nipple is removed as part of the mastectomy, you may have a surgical nipple reconstruction with or without a tattoo at the same time as your breast reconstruction or at a later date.
- Drainage tubes may be inserted into the area.
- The incision will be closed with stitches or adhesive strips and a sterile bandage or dressing will be applied over the site.
After Surgery & Recovery
Recovery from this type of mastectomy will take several weeks, so you should be prepared to take things easy at first. Depending on the type of reconstruction you had, you should be able to walk and move around but shouldn't lift anything heavier than about 5 pounds. You should also ensure you get plenty of rest.
During your hospital stay, you'll be taken to the recovery room after the procedure. There, you'll be closely monitored until your vital signs like blood pressure, pulse, and breathing are stable, and you're awake and alert. Once you're stable, you'll be moved to your hospital room.
Typically, you'll stay in the hospital for 1 to 3 days after a mastectomy, depending on the extent of the surgery and whether you had breast reconstruction. Some types of reconstruction using flaps of your own tissue require more extensive surgery that may result in spending as much as a week in hospital.
Once you're home, it's important to keep the surgical area clean and dry, following your doctor's instructions. You'll also need to care for the drainage tube, which is usually removed after about 2 weeks at your first follow-up exam.
You may experience some pain, which can vary depending on the surgery. Your healthcare team will recommend pain relievers, but be cautious about taking aspirin or certain other pain medicines that may increase the risk of bleeding.
You can typically resume normal activities in a few weeks, but you should avoid strenuous activities in the meantime. Your surgeon will advise you on when you can drive again and return to work.
If you're having difficulty coping with your recovery, you may find it helpful to speak to your loved ones or to join a support group for assistance. This can help you cope with the emotional aspects of undergoing this type of surgery.
Contact your doctor if you experience fever, chills, increased pain, swelling, or any other concerning symptoms after surgery.
Ultimately, the decision to undergo a prophylactic/preventative mastectomy should be made after careful consideration of all factors involved, including personal health history, genetic predisposition, lifestyle factors, emotional readiness, and support systems in place. Consulting with healthcare providers, genetic counselors, psychologists, and other experts can help you make informed decisions.
A prophylactic mastectomy can give you peace of mind and the confidence of taking your healthcare into your own hands. Contact us today [Link to Contact] for a confidential conversation by video call directly with one of our expert surgeons. We are more than happy to discuss your treatment options with you if you are at a high risk for contracting breast cancer and help you make the right decision to align with your values and goals for long-term health and wellness.