According to the American Cancer Society 268,600 women were diagnosed with breast cancer in 2019. That same year, roughly 41,760 women died from the disease 1. Preventive mastectomy, also known as prophylactic or risk-reducing mastectomy, is a procedure designed to reduce the risk of developing breast cancer by surgically removing one or both breasts before the disease has formed. The National Cancer Institute states that this procedure may reduce the chances of developing breast cancer in moderate-to-high risk women by up to 95% 2. Those who choose to have a preventative mastectomy should know their breast reconstruction options following a preventative mastectomy.
At LIPSG, we are a compassionate team of caregivers dedicated to supporting our patients through every aspect of the preventative mastectomy and breast reconstruction process. While one of our doctors will be happy to meet with each patient in an initial consultation at our Long Island and New York-area facilities to discuss all aspects of breast reconstruction, the following information will provide introductory details regarding the procedure. Please contact LIPSG for more information on preventative breast cancer surgery from our Manhattan and Long Island, New York plastic surgeons.
Identifying Risks for Developing Cancer: Genetic Testing
In recent years, tests have become available that allow doctors to screen patients and determine their risk for developing certain types of cancer, including breast cancer. These tests are by no means conclusive evidence that cancer will develop; however, they can supply an idea of the patient’s potential for developing cancer later in life based on various genetic factors. Therefore, many patients choose to have genetic testing for cancer in order to start taking steps that may help them reduce the risk. For patients looking to identify their risk for breast cancer, or any other form of cancer, an educational consultation with a general practitioner, a geneticist, or one of our LIPSG plastic surgeons is the first step in addressing hereditary concerns associated with heightened risks for developing cancer.
Reasons for Having a Preventive Mastectomy
A preventative mastectomy is typically performed on women who are considered to have a moderate to high risk of developing breast cancer. The National Cancer Institute lists several reasons why some women have a preventative mastectomy, which include:
- Women who have had breast cancer in one breast are more likely to develop cancer in the other breast.
- A family history of breast cancer. Those who have a sister, mother, or daughter who have had breast cancer, particularly if they were diagnosed before the age of 50, are often at a higher risk of developing breast cancer themselves. Women who have a family history of ovarian cancer may also have an even higher risk of developing breast cancer.
- Radiation therapy to the chest and breasts before the age of 30 increases the risk of developing breast cancer. This is including women who have been treated for Hodgkin’s lymphoma.
- Women who test positive for particular gene mutations or changes that increase the risk of breast cancer have a higher chance of developing breast cancer.
- Women who are diagnosed with lobular carcinoma in situ (LCIS) – a condition caused by abnormal cells found in the breast – are at an increased risk of cancer in either breast. 3
Regardless of whether there is an increased risk of breast cancer due to the above reasons, or any additional possibilities, women should always talk with their doctor about all aspects of preventative mastectomy and their own risks of developing breast cancer. The actual procedure, potential complications, and a patient’s own unique risk factors should all be thoroughly discussed and considered before deciding to proceed with a preventative mastectomy. At LIPSG, our surgeons will work with each patient and all involved doctors and surgeons to create a personalized, collaborative approach to the entire breast reconstruction procedure.
Nipple Sparing with a Preventative Mastectomy
Nipple sparing is a technique that can often be used in conjunction with a preventative mastectomy procedure at LIPSG to preserve the nipple during the breast reconstruction process. With the nipple sparing procedure, the incision to remove the breast tissue is made around the nipple and areola, allowing our surgeons to preserve a more natural appearance while avoiding the need for nipple tattooing or reconstruction. However, patients must realize that while reduced, the risk for breast cancer still exists as the nipple contains breast tissue, therefore must be screened annually.
With the preventative mastectomy, the skin sparing technique is also an option that allows our surgeons to remove the breast tissue while preserving the skin of the breast. The skin sparing procedure results in fewer scars while saving a greater percentage of the breast tissue to ensure more natural breast reconstruction results. However, as with the nipple sparing procedure, some breast tissue remains and should be screened on a regular basis.
Preventative Mastectomy Statistics
According to the National Cancer Institute, some studies indicate that a preventative mastectomy may diminish the risk of developing breast cancer by 95 percent in moderate-to-high risk women. However, there is no concrete certainty that this procedure can completely prevent breast cancer, as breast tissue is present in a variety of areas in the chest, and can even be found in other parts of the body such as the armpit, collarbone, and abdomen. Therefore, all patients at risk for breast cancer should address all breast cancer treatment options with our LIPSG surgeons, including preventative mastectomy, and continue to be screened annually.
Alternatives to Preventative Mastectomy
Patients with a family history of breast cancer and those with other risk factors may benefit from a variety of alternatives to preventative mastectomy. Regular breast exams and mammograms, as well as self-examinations, can better the chances of discovering early-stage breast cancer. There are also some medications that may reduce the chances of developing breast cancer in high-risk women. Changes in diet and alcohol consumption may also be beneficial. Again, all alternatives should be explored with a healthcare provider before deciding to undergo preventative mastectomy.
Plastic and reconstructive surgeons with Long Island Plastic Surgical Group’s Breast Reconstruction Surgery Center are specialty-trained in a variety of breast reconstruction techniques. Our doctors have been educated and trained in some of the most well-known medical institutions and cancer research hospitals in the world, including Memorial Sloan Kettering Cancer Center. Doctors at our practice are experienced with every major breast reconstruction technique, and have performed more than 10,000 breast reconstruction procedures combined.
At LIPSG, our plastic and reconstructive surgeon will meet with each patient in an initial consultation to discuss all aspects of breast reconstruction, from the many techniques we perform, to pre-operative and recovery expectations. A top priority here at the Breast Reconstruction Center is to create a team environment, as we believe involving our patients in every step of the process is a necessary step in achieving successful results. Our doctors, surgeons, and staff at LIPSG emphasize this collaborative effort throughout the entire breast reconstruction process, to ensure our patients are well-educated and able to make informed decisions concerning their treatment.
Our reconstructive surgery team also extends this collaborative approach to other medical professionals involved in patient care during the breast reconstruction process. We work closely with our patients’ breast surgeons, radiologists, oncologists, and a number of other specialists with first-hand knowledge of all treatment options involved with a preventative mastectomy and breast reconstruction procedure. By fostering this all-encompassing approach to rebuilding our patients’ physical, mental, and emotional well-being, LIPSG is able to provide the best possible approach to achieving successful breast reconstruction results.
In an effort to supplement the expertise of our surgeons at LIPSG Breast Reconstruction Center, as well as the combined expertise of the entire collaborative team associated with our patients’ breast reconstruction following a preventative mastectomy, LIPSG also offers the most innovative technologies available to provide our patients with a clear representation of our approach and procedures. With technology like Vectra 3D imaging, our surgeons are able to help each patient develop realistic expectations by providing them with the ability to view the best possible results of breast reconstruction before setting foot in the operating room.
Contact our LIPSG Plastic and Reconstructive Surgeons
The surgeons at our Breast Reconstruction Surgery Center here at the Long Island Plastic Surgical Group can provide additional information on breast reconstruction after preventative mastectomy. We will be happy to answer any questions about preventative mastectomy and cover all reconstructive surgery options. Please contact LIPSG to schedule a consultation.
1 American Cancer Society. Breast Cancer Facts & Figures 2019-2020. Available: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2019-2020.pdf. Accessed November 6, 2020,
2 National Cancer Institute. Surgery to Reduce the Risk of Breast Cancer. Available: https://www.cancer.gov/types/breast/risk-reducing-surgery-fact-sheet#:~:text=Bilateral%20prophylactic%20mastectomy%20has%20been,cancer%20(2%2D5). Accessed November 6, 2020.
3 BreastCancer.org. Is prophylactic Mastectomy Right for You? Available: https://www.breastcancer.org/treatment/surgery/prophylactic_mast/right-for-you. Accessed November 6, 2020.