UM Guidelines
Mastectomy, Complete, with Tissue Flap Reconstruction

Inpatient and Surgical Care (ISC)

BCBST last reviewed September 10, 2026*

Added to Clinical Indications:
   
Procedure may be indicated for 1 or more of the following:
 
 
  • Procedure is indicated for...
    • [Patient or provider preference over partial mastectomy]*
    • ...
    • Bilateral prophylactic mastectomy (no current diagnosis of breast cancer), as indicated by...
      • Significantly elevated risk of breast cancer, as indicated by...
        • [Lobular carcinoma in situ]*
        • ...
   

References

  1. American Cancer Society. (2026, July). Mastectomy. Retrieved July 16, 2026 from https://www.cancer.org/.
  2. BlueCross BlueShield Association. Evidence Positioning System. (2025, November). Risk-reducing mastectomy (7.01.09). Retrieved July 2, 2026 from https://www.bcbsaoca.com/eps/. (30 articles and/or guidelines reviewed)
  3. National Cancer Institute. (2025, December). Surgery to reduce the risk of breast cancer. Retrieved July 02, 2026 from https://www.nih.gov/institutes-nih.

 

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