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Prophylactic Mastectomy: A Pre-Emptive Move Against Breast Cancer

For some women, this procedure may be an effective measure. But it's important to talk with your doctor if you think you're at high risk for breast cancer.

Imagine cutting off a part of your body that is perfectly healthy in the hopes of avoiding a disease down the road.

That might sound a little extreme. But for some women with a high risk of developing breast cancer, removing one or both breasts before the disease strikes is a medically viable option.

The procedure is called a prophylactic mastectomy. And women who decide to have this preventive surgery may do so because they’ve inherited a harmful mutation—or change—in one of the genes known as BRCA1 and BRCA2.

What are these genes?

Both BRCA1 and BRCA2 are a type of gene called tumor suppressors. Their role is to help stabilize a cell’s DNA and prevent uncontrolled cell growth.

Inheriting dangerous changes in these two BRCA genes greatly increases a woman's risk for getting breast cancer—as well as ovarian cancer—before age 50.

Genetic testing can identify these gene changes. But testing is only recommended for women at high risk of breast or ovarian cancer. That includes women who are of Ashkenazi, or East European, Jewish heritage and those who have:
  • Two immediate family members with breast cancer—one of whom was diagnosed before age 50
  • Three or more close relatives with breast cancer
  • Two or more close relatives with ovarian cancer
  • A male relative with breast cancer

Some things to consider

If you think you’re at high risk for breast cancer, talk to your doctor about what your options may be, including genetic counseling and testing.

You should also know that:
  • Health insurance often covers genetic counseling, but it may not pay for testing. Check your individual plan.
  • A prophylactic mastectomy significantly reduces the risk of breast cancer but doesn’t eliminate it entirely.
  • Surgery is one option for preventing breast cancer if you’re at high risk. Others include close monitoring with mammograms and other tests or taking medications—either tamoxifen or raloxifene—that can lower your risk.

Additional sources: American Cancer Society; Current Oncology, Vol. 17, No. 2; National Cancer Institute
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