I have a strong family history of cancer. I need a breast reduction anyway. I don't know what specialty is best for a prophylactic mastectomy. Will I have to have a referral?
What Medical Specialty is Best for Prophylactic Mastectomy?
Doctor Answers (4)
can be done by either the breast surgeon or your plastic surgeon (if they still remember how to do it from their general surgery days). Prophylactic mastectomies do not require any 'extra' work or nodes biopsies... and breast surgeons have a tendency to treat your breast as if you had cancer, resecting excessive amounts of tissue and skin. No surgeon can completely clear you of your breast tissue so if a breast surgeon leaves 5% behind and I leave 7%, does that really matter? I think not and prefer to do the mastectomies myself as I can determine what incisions are best (and yes, there are better incisions for this) to give you the best outcome.
A prophylactic mastectomy is probably best done by a breast cancer surgeon. While a plastic surgeon can perform it as well, I think the former should be the one you go to.
Doctor for prophylactic mastectomy
I recommend that my patients see a breast oncologic surgeon for all breast related disease matters and prophylactic mastectomy. A breast oncologic surgeon is a general surgeon who has had additional fellowship training in breast surgery (beyond residency). Since both your oncologic and aesthetic results will depend heavily on the skill and knowledge of the surgeon who does your mastectomy/mastectomies, I suggest that you see a specialist who focuses on breast surgery.
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Best Specialist for Prophylactic Mastectomy
I refer my patients considering a prophylactic mastectomy to a dedicated breast oncologic surgeon. These are surgeons who devote the majority of their practice to breast cancer surgery. They are well versed in mastectomy, lumpectomy, sentinel lymph node biopsy, axillary dissection, and most importantly understand the appropriate workup and management of a patient with strong family history of breast cancer.
These surgeons are also well trained in skin and nipple sparing mastectomies, which allow for the most aesthetically pleasing breast reconstruction. They also work with your plastic surgeon to coordinate an immediate reconstruction of your breast.
Depending on your insurance plan, you may need a referral from your primary care physician to see the breast surgeon and begin the approval process for prophylactic mastectomy. All the best.
Paul S. Gill, M.D.
GIll Plastic Surgery
Houston Double Board Certified Plastic Surgeon