Treatment Options

Prophylactic Mastectomy

Moderate Value

Prophylactic mastectomy is the surgical removal of the entire breasts, including the nipples and surrounding areas, in an attempt to reduce the risk of breast cancer. Before making a decision regarding this surgery talk with your health care provider to learn your actual risk of developing breast cancer. Determine the type of surgical or treatment options available to you as well as the advantages and the disadvantages of each option. You need to know the physical and emotional consequences of your decision. If you decide to have the prophylactic mastectomy, you need to prepare for the assistance you will require while recovering from the surgery.

Things to Consider

  • Only women with a very high risk of breast cancer due to a personal history, a high risk family history or abnormal genes known as BRCA1 or BRCA2 should consider prophylactic mastectomy.
  • Prophylactic oophorectomy or removal of the ovaries is a procedure used to lower the risk of ovarian cancer as well as breast cancer, especially women who have not experienced menopause.

Results

Moderate Value

Will I live longer if I have this procedure?

If you have a very high risk of breast cancer, the prophylactic mastectomy may dramatically reduce your risk for breast cancer. It will not guarantee that you will never get breast cancer.

Will prophylactic mastectomy improve my quality of life?

Removal of your breasts may reduce your feelings of risk and fear of breast cancer. It may affect your body image and feelings of sexuality. Many women chose to have reconstructive breast surgery after the mastectomy. You and your health care provider will determine your options regarding this surgery and if reconstructive breast surgery is best for you.

Will prophylactic mastectomy make my symptoms better?

Prophylactic mastectomy would take place before you develop symptoms of breast cancer.

Safety

Moderate Value

How safe is this procedure?

Mastectomies are generally safe and free of complications.  However, any surgical procedure involves some risk and may result in complications or death.

Minor reported complications:

  • Minor pain
  • Scaring

Major reported complications:

  • Bleeding
  • Blood clots
  • Infection
  • Numbness under the arm that may be permanent
  • Reduced sensitivity and sexual response
  • Scarring
  • Severe pain
  • Swelling known as lymphedema in your arm(s) and hand(s) that may be permanent

Comparison

Moderate Value

Women who want to aggressively deal with their risk of breast cancer may choose prophylactic surgery. For women who want to be less aggressive there are alternative treatments. No matter what the choice, a woman with BRCA1 or BRCA2 gene abnormality should follow closely with her breast care specialist and discuss their best screening plan.

Alternative treatments include:

  • Watch and wait
  • Chemoprevention medication
  • Prophylactic oophorectomy before menopause

Preventative measures that have been associated with a reduced risk of breast cancer in high-risk women include the following:

  • Avoidance of estrogen
  • Avoidance of smoking
  • Healthy diet and healthy-life style
  • Limited alcohol intake
  • Regular exercise
  • Weight control

Cost

Moderate Value

The approximate cost for prophylactic mastectomy, including the physician and facility charges, may be over $15,000. The costs could vary depending on the physician, the facility, the geographic location, as well as any special needs or complication you may experience.

The cost may or may not be covered by your health benefits plan.

Sources

The following are off-site links off-site link :

American Cancer Society. (2013, September). Breast cancer overview. Retrieved January 9, 2014 from
http://www.cancer.org/Cancer/BreastCancer/OverviewGuide/breast-cancer-overview-prevention.

Mayo Clinic. (2011, December). Prophylactic mastectomy: Surgery to reduce breast cancer risk. Retrieved January 9, 2014 from http://www.mayoclinic.com/health/prophylactic-mastectomy/WO00060.

Society of Surgical Oncology. (January, 2007). Society of Surgical Oncology: Position statement on prophylactic mastectomy. Retrieved January 9, 2014 from
http://www.surgonc.org/practice-policy/practice-management/consensus-statements/position-statement-on-prophylactic-mastectomy.

Next Review Date

1/23/2015

This document has been classified as public information.

Table of Findings

results:  moderate value

safety:  moderate value

comparison:  moderate value

cost: moderate value


total: moderate value

legend

scale

Page modified:January 31, 2014