Breast cancer

Prophylactic Mastectomy

In prophylactic mastectomy, one or both breasts that have no sign of cancer are removed to reduce the risk of breast cancer in the future. This procedure is also called preventive or risk-reduction mastectomy.

Prophylactic mastectomy and breast reconstruction are major surgical procedures with lasting effects on body appearance. Prophylactic mastectomy is generally reserved for patients who are at very high risk for developing a first or second breast cancer. There is no guarantee that patients identified as high-risk will develop cancer. There is also no guarantee that the risk of developing cancer will be eliminated by prophylactic mastectomy. Breast tissue is widely distributed on the chest wall and also can be found in the armpit, above the collarbone or as low as the abdomen. Any remaining breast tissue may still develop breast cancer.

At Mayo Clinic, specialists work with each patient to assess the risk of breast cancer and determine whether prophylactic mastectomy is an appropriate treatment option. Reasons to consider prophylactic mastectomy include family history, genetic factors, anxiety reduction and symmetry.

Family history

A significant family history of breast cancer (a mother, sister or daughter diagnosed with breast cancer at a young age) may be a reason to consider prophylactic mastectomy, although 85 percent of breast cancers occur in women with no prior family history of the disease.

Women may overestimate their risk of breast cancer based on family history. At Mayo Clinic, genetic specialists consult with patients to help define and estimate the risk of hereditary genetic disposition for breast cancer and to determine whether a patient is a candidate for prophylactic mastectomy.

Genetic factors

Mayo Clinic offers a full range of genetic testing and counseling. Genetic testing may identify patients with an abnormal breast cancer gene (BRCA1 or BRCA2) associated with inherited types of breast cancer. Patients with a family history of breast or other cancers should discuss genetic testing with their health care provider.

Anxiety reduction

If a patient has had one breast removed because cancer was present, a prophylactic mastectomy may reduce anxiety about cancer developing in the unaffected breast.

Symmetry

Some women who have a mastectomy choose to have the unaffected breast removed as well to give their body a more even appearance.

Prophylactic mastectomy may reduce the risk of breast cancer, but it does not guarantee that the patient will not develop cancer. There is no evidence that prophylactic mastectomy improves survival rates after a diagnosis of breast cancer.