Prophylactic Mastectomy to Prevent Breast Cancer
Women with a family history of breast cancer, or those who have tested positive for the BRCA gene mutation, often face the question of whether to have a preventative mastectomy. Deciding to have a prophylactic mastectomy to reduce the risk of developing breast cancer can be one of the most personal and difficult decisions a woman makes in her life. Recent advances in breast reconstruction techniques have given patients more options than ever; these options enable the patient and surgeon to select a procedure that best meets the individual patient's needs. Dr. Oren Lerman is a highly-regarded breast reconstruction surgeon dedicated to providing the best in care to breast cancer patients. With his specialized training and compassionate bedside manner, he can perform the most advanced reconstructive procedures after preventative (prophylactic) mastectomy. Schedule your consultation with us today at Dr. Lerman's Manhattan office to learn more about your options for prophylactic mastectomy and reconstruction.
Candidates for a Preventative Mastectomy
One out of every eight women in the United States develops breast cancer. Most cases occur in the later decades of life. Some women, however, are at a significantly increased risk of developing breast cancer at a young age. For these women, breast cancer can occur much earlier, and the odds of developing it can be as high as 80 percent. To reduce this risk, these women may choose to undergo a prophylactic mastectomy. High risk patients include those with:
- A Family History of Breast or Ovarian Cancer: Breast cancer in a close female relative, such as a mother, sister, maternal aunt or grandmother, especially if diagnosed before the age of 50, can be a clue that someone has an increased risk for developing breast cancer themselves. Also, having multiple family members with breast or ovarian cancer can put you in this high risk category.
- Breast Cancer in One Breast: Women who have had breast cancer in one breast, especially if they have a strong family history of breast cancer, may elect to have the other breast removed.
- Positive BRCA Testing: Testing with a simple blood sample or oral swab can identify mutations to genes BRCA1 and BRCA2, which help the body fight breast cancer. In fact, a mutation in either gene can increase your breast cancer risk up to 80 percent. Identifying BRCA carriers before the disease develops gives these patients the knowledge they need to proceed with risk reduction surgery - prophylactic mastectomy before a breast cancer develops.
Deciding to Have a Prophylactic Mastectomy
Patients should work closely with health professionals to educate themselves on treatment options. The decision to go through with a preventative mastectomy is generally not an urgent one, and patients should give themselves the time to weigh the pros and cons. Patients may also want to meet with a breast surgeon and genetic counselor, as well as a reconstructive plastic surgeon who specializes in breast reconstruction.
Nipple Sparing Mastectomy
Traditional mastectomy techniques remove the nipple and areola with the breast tissue. When performing a prophylactic mastectomy, many patients choose to have a nipple sparing technique where the entire nipple and areola are preserved as part of the skin and only the breast tissue is removed. When the most advanced breast reconstructive techniques are combined with nipple sparing mastectomy surgery, a patient can look as if no mastectomy was ever performed. Indeed, in some patients, the reconstructive surgery can actually improve the appearance of the breast. Nipple sparing techniques have their own set of challenges and should be performed by an experienced team including the breast surgeon and a specialized reconstructive plastic surgeon such as Dr. Oren Lerman.
Women who choose to undergo a preventative mastectomy can benefit from a number of recent innovations in breast reconstruction techniques. A number of less invasive and more natural breast restoration options are available:
- DIEP flap
- GAP flap
- PAP flap
- TUG flap
- TAP flap surgeries.
Patients can also benefit from advances in implant reconstruction, whether done in a two stage manner with a tissue expander, or with a Direct-To-Implant one stage reconstruction. The Direct-To -Implant reconstruction avoids months of tissue expansion and a second surgery. All of these techniques allow woman undergoing prophylactic mastectomy to go back to their normal lives with the knowledge that they may very well look as good or better than they did before surgery. Your options have never been greater, and with a breast reconstruction specialist who can offer you all the most advanced options, you can enjoy improved peace of mind during the process when you are contemplating prophylactic mastectomy. The knowledge that you can look and feel beautiful and comfortable with your body after surgery often gives woman the power they need to make the decision to proceed with this potentially life saving risk reduction surgery.
Contact Us Today
Dr. Lerman and his team feel strongly that the decision to undergo preventive mastectomy cannot be made until you have learned about all of your reconstructive options. There is no single option that can satisfy the needs of all patients. Natural tissue perforator flaps may be the best option for some, while implants may be better for others. It is also possible to switch from one to the other later in life. It is imperative that you have all the options available offered to you by your reconstructive surgeon in order to be able to make the right choice for yourself. Please contact us today to schedule a consultation and learn about the therapies available to you.
“The one thing that is most important when we're doing cosmetic surgery and aesthetic surgery of the face or the body is to make sure that the patient is happy afterwards...” Dr. Oren Lerman