Plastic Surgeon Questions Breast Cancer

Does a double mastectomy prevent breast cancer?

I have a family history of breast cancer, and I want to have a double mastectomy because my doctor told me that I was at a high risk. Would this prevent breast cancer?

12 Answers

It will dramatically lower your risk to below the average risk of the general population.
A bilateral preventative (prophylactic) mastectomy is highly effective in reducing the risk of breast cancer developing. It does not eliminated completely but makes it very unlikely to occur. However, just because you have a family history does not mean you must have a pre vented of mastectomy. Be sure your surgeon is intimately familiar in assessing the risk of breast cancer occurring in her case
Bilateral mastectomy does significantly decrease your risk for breast cancer but does not irradicate it completely due to the potential for retained breast tissue cells in the surgical site. Routine exams by your surgeon and yourself would be recommended for continued follow up in patients with family history of disease.
A double mastectomy is protective for breast cancer. If there is no breast tissue left then cancer cannot grow. However, even if you have a risk reducing double mastectomy, it is nearly impossible to remove every bit of breast cancer. You should always be aware of any changes to your breasts even after surgery. While the chance of developing a tumor in residual breast cells is quite low, it is not zero.
It decreases your chance of breast cancer significantly. Mastectomy removes usually 96-98% of breast tissue.
Women who inherit a deleterious mutation in the BRCA1 gene or the BRCA2 gene or mutations in certain other genes that greatly increase the risk of developing breast cancer may consider having a bilateral prophylactic mastectomy and/or a bilateral prophylactic salpingo-oophorectomy to reduce this risk.

Yes, it prevents breast cancer. You can take a DNA test before.
Patients who are genetically predisposed to developing breast cancer are strongly advised to consider bilateral mastectomy to reduce the risk of developing breast cancer in the future. Usually, a strong family history will be a reason to have genetic testing done. After the double mastectomy, the chances of having breast cancer are reduced to nearly zero, so the terminology is "risk reduction." In some types of genetic situations, there are other associated cancers that may also need to be prevented with ovary and/or uterus removal as well, so it's important to have some specific genetic testing results and be counseled so you can make the appropriate informed decisions.
A double mastectomy should reduce the cancer risk to almost zero. In an extremely small instance, there could be breast cancer if you have something called 'ectopic breast tissue'. That is usually in the fatty tissue going up toward your armpit. That fat should be removed to lessen the even small risk but I would not suggest removing any lymph nodes as they can present a final barrier to the spread were anything unexpected were to happen
A mastectomy removes ALMOST all of the breast tissue and as such cannot guarantee that a patient will not develop breast cancer. Having said that, breast cancer ALMOST never occurs outside the breast. So the answer is PROBABLY but not definitely.

I hope that helps.

Dr Mes
Thank you for the question. Breast cancer arises from the breast tissue contained in the breast. It is a well-defined tissue. If the whole breast tissue is removed, this would definitely prevent the occurrence of breast cancer. You may want to discuss this with your surgeon for further details.

Luis A. Laurentin-Perez, MD PhD.
There are some very specific indications for “prophylactic” or risk reduction mastectomy. Those are better discussed with a surgical or breast oncologist. The term risk reduction tells it all: it significantly reduces the risk of breast cancer, but does not eliminate it.

Hugo St-Hilaire, MD, DDS, FACS