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Undergoing a Mastectomy as a Prophylactic Measure

April  29,  2019 in

Much of the time, doctors treat a patient’s cancer reactively. It’s only after the disease is detected that the patient will undergo radiation, chemotherapy, surgery, or other forms of treatment.

In some cases, however, doctors do treat cancer proactively. That is, they’ll take steps to combat the disease even before it becomes present. In medical terms, this is called a “prophylactic measure.”

Prophylactic measures are sometimes used for patients who are at a very high risk for developing diseases like breast cancer. This preemptive surgery on one or both breasts is called a mastectomy or double mastectomy respectively. “The surgery aims to remove all breast tissue that potentially could develop breast cancer,” explains WebMD.

A mastectomy may seem like a drastic approach. However, it can seriously reduce the chance of the cancer emerging — and, as a result, avoid long, painful, and less-effective treatments down the line. “A prophylactic mastectomy has been shown to reduce the risk of breast cancer by at least 95 percent in women who are at a high risk for the disease,” says the National Cancer Institute.

The procedure is also becoming more common: “Rates of [prophylactic mastectomies] have increased dramatically in the past decade,” says Susan G. Komen, the breast cancer awareness organization.

There are many factors that determine whether or not a prophylactic mastectomy is the right decision for a patient. Chief among them include:

An existing case of cancer in one breast

“If you need to have one breast removed because of a new cancer diagnosis, and you have a hereditary breast cancer mutation… you may decide to have the other, unaffected breast removed at the same time,” reports the Mayo Clinic. This proactive step can “greatly reduce” the chance of the cancer reemerging later in life. Susan G. Komen has a helpful article on this topic titled, “Now that I have breast cancer on one side, should I remove both breasts?”

Past exposure to radiation

“Those who have had radiation therapy to the chest (including the breasts)… are at high risk of developing breast cancer throughout their lives,” says the National Cancer Institute. This previous exposure might be because of a past treatment for another cancer. The American Cancer Society says those who “had radiation therapy to the chest before age 30 are at a higher risk for developing breast cancer, and may want to consider preventative measures.

A family history of breast cancer

With cancer — and many other diseases — your family tree provides insight into what illnesses you’re most likely to develop. “If your mother, sister or daughter has had breast cancer, especially if she was diagnosed before age 50, you may be at increased risk,” according to the Mayo Clinic. If relatives have had ovarian cancer, that can be another signal that you’re at a high risk of breast cancer. “A woman who has a first-degree female relative with breast cancer has about twice the risk of a woman without this family history,” says Susan G. Komen.

The presence of a certain mutation

A specific genetic mutation, called BRCA1 or BRCA2, can signal that you’re at a high risk for breast cancer. “Prophylactic mastectomy in women who carry a BRCA1 or BRCA2 gene mutation may be able to reduce the risk of developing breast cancer by 95%,” reports BreastCancer.org. You can determine if you have this mutation by undergoing a DNA test. A nurse or doctor will draw blood, then ship it to a facility for analysis.

Undergoing a prophylactic mastectomy is a major decision. Like any important medical decision, it’s critical to do research, obtain multiple opinions, and consider how it will affect your quality of life.

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