At What Age Should You Get a Preventative Mastectomy?

The female gender and older age are risk factors for developing breast cancer.

A person may choose to undergo a prophylactic mastectomy due to the following:

• Breast cancer in the close family: If a member of your immediate family, such as your mother, daughter, or sister, has had breast cancer, your risk of developing the disease is much higher. If they had developed breast cancer before 50 years, the risk is even higher.
• Personal breast cancer history: You may decide to have the other breast removed if you already have breast cancer in one breast and require a mastectomy. However, this has no impact on your prognosis or the need for further therapy to treat your breast cancer.
• Positive genetic test results: Genetic testing checks for gene changes (mutations) in the BRCA1 or BRCA2 genes. You may decide to undergo a preventive mastectomy if you test positive for these mutations.
• Radiation therapy: Your risk of developing breast cancer is higher if you have ever received chest radiation therapy, especially between 10 and 30 years old.

People getting prophylactic mastectomy will have one of the following procedures:

• Simple or total mastectomy: Involves the removal of the entire breast, including the nipple and areola. There is no muscle removal or axillary lymph node dissection (removal of the underarm lymph nodes).
• Radical mastectomy: The nipple, areola, surrounding skin, lymph nodes beneath the arm, and the chest muscles under the breast are resected along with the complete breast. This procedure is currently outdated and used rarely. It might be indicated when breast cancer has affected the chest muscles.
• Modified radical mastectomy: The entire breast is removed. This includes the nipple, the areola, the skin on top, and the lining around the chest muscles. Additionally, some of the lymph nodes under the arm are removed. These lymph nodes are frequently affected by the spread of breast cancer. After then, it might spread to other body regions. Sometimes, a portion of the muscle that lines the chest wall is taken off.
• Skin-sparing mastectomy: The surgeon merely removes the skin from the nipple, areola, and the initial biopsy scar. The surgeon next uses the little opening that was recently created to remove the breast tissue. The remaining pouch of the skin provides the perfect shape and form for an implant (a reconstruction built from your tissue). Skin-sparing mastectomy should be done quickly after a simple or total mastectomy to get the skin needed for quick reconstruction.
• Nipple-sparing mastectomy: The entire breast is removed except for the nipple.

Immediate risks

• Bleeding or infection
• Fluid collecting under the scar (seroma)
• Delayed wound healing
• Scar tissue formation

Long term risks

• The considerable reduction of breast feeling caused by the surgery may influence sexuality.
• Breastfeeding is not possible for the person.
• Some women have reported melancholy or anxiety related to their bodies.
• Although a preventative mastectomy can reduce the risk of breast cancer by roughly 90 percent, it cannot prevent it from ever occurring. In extreme cases, breast tissue might reach the collarbone and armpit and can arise from them.

If you decide against undergoing a preventative mastectomy but are still at high risk for breast cancer, here are options for early detection and risk reduction.

• Medications: The hormone estrogen may encourage the growth and development of breast cancer. You can lower your risk of breast cancer by taking drugs that inhibit the effects of estrogen or lower your body's production of estrogen. The choices include:
  • Tamoxifen for premenopausal or postmenopausal women
  • Raloxifene for postmenopausal women
  • Exemestane for postmenopausal women
  • Anastrozole for postmenopausal women
• Breast cancer screening
• Prophylactic oophorectomy (surgery to remove the ovaries)
• Healthy lifestyle