What Every Woman Should Know About Preventive Mastectomy

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Since Angelina Jolie's announcement that she had bilateral mastectomy a couple of weeks ago, there has been a lot of interest in this type of surgery. I would like to address a couple of issues that are very important for women to understand.

Mastectomies (surgical removal of breast tissue) are performed for essentially two reasons: removing cancer and preventing cancer from forming. Across the board, women have about a 12 to 13% risk of developing breast cancer during the course of their lives. This risk increases when there are certain genetic abnormalities. The most common ones are the BRCA mutations. If a woman is affected with one of these mutations, her likelihood of developing breast cancer can go up to 80 or 90%. Therefore, these women (such as Angelina Jolie) often have their breast tissue removed in order to prevent breast cancer from occurring.

Sometimes, a woman who has breast cancer on one breast may choose to have the breast tissue from the opposite breast removed as well. The reasons for this include prevention of future breast cancer on the opposite breast, and also the ability to obtain a better and more symmetrical reconstruction of the two breasts.

The surgeries on both breasts are covered by insurance. In the same way, that any surgery on the breasts after a diagnosis of breast cancer is automatically covered by insurance. When a woman is having prophylactic mastectomy for prevention of cancer, the best option is to perform a nipple-sparing mastectomy. In a traditional skin sparing mastectomy, the breast tissue is removed and the nipples and areolas are removed as well. In a nipple sparing mastectomy a small Incision is made and all of the breast tissue is removed without removing the nipple or any of the skin. The result is that the breast can be reconstructed to look perfect and in some cases even better than before surgery. 

Women with strong family histories of breast cancer should talk to their doctors about getting tested for the BRCA mutations. These women should also begin having mammograms at a younger age than normal (the typical age to begin mammograms is 40 years of age). Again, talk to your doctors about getting these important tests done at an earlier age.

Article by
Thousand Oaks Plastic Surgeon