Prophylactic mastectomy refers to mastectomies performed for preventive reasons, in patients who do not yet have breast cancer. The popularity of prophylactic mastectomy has grown recently as a result of the discovery of the BRCA-1 and BRCA-2 genes. Patients who carry these genes have a significantly higher risk of developing breast cancer in their lifetime. The BRCA genes are used in combination with modern risk-assessment tools that strongly weigh a woman’s family history of breast cancer. Together, they help to identify patients at “high risk” of developing breast and even ovarian cancer.

Patients with a significant family history of breast or ovarian cancer are usually sent to a geneticist for counseling. With additional help from a breast surgeon and plastic surgeon, you can decide whether or not prophylactic mastectomy and breast reconstruction is the right decision for you.

Some of the best cosmetic results in breast reconstruction are achieved in prophylactic mastectomy patients. The biggest advantages include not having to contend with a tumor during the mastectomies and being able to spare the patient’s nipples, leading to very natural results. The plastic surgeon can perform the reconstruction at the same time as the mastectomy, so that the patient wakes up from the procedure with breasts. This has made the decision of undergoing prophylactic mastectomy and reconstruction much easier for women considered “high risk.”