A preventative mastectomy or prophylactic mastectomy is an elective surgery to remove the breast so that the risk of breast cancer is reduced.
Video Preventive mastectomy
Indication
This procedure is a surgical option for individuals at high risk of developing breast cancer. Women who underwent bilateral mastectomy in 2013 about 10 years younger than those with unilateral mastectomy.
This prevention operation is associated with women with these characteristics:
- BRCA1 or BRCA2 carrier mutation; this is a major indication for bilateral prophylactic mastectomy.
- Cancer in one breast and a family history of breast cancer.
- Family history of breast cancer. Genetic risk can be decreased through the mother or father side.
- Radiation therapy to the chest before the age of 30 years.
- The presence of lobular carcinoma in situ.
- Have dense breasts or breasts with diffuse microcalsification, as screening for breast cancer becomes difficult.
Discussions and decisions should be made with the help of specialists who can use relevant information and statistical models to predict the lifetime risk of individual breast cancer development.
Undergoing preventative mastectomy does not guarantee that breast cancer will not develop later, however, reducing the risk by 90% in high-risk women. Also, a preventative mastectomy may not be able to lift all breast tissue as it may partially be in the armpit, near the neck bone, or in the abdominal wall.
BRCA1 and BRCA2 mutation carriers have a higher risk of developing breast cancer than other men, about 1.2% and 6.8%, but the risks are much lower than that of the female mutation carriers (about 60%) and lower than in the general female population (12%). Thus, preventive mastectomy has not been recommended for men affected.
Maps Preventive mastectomy
Procedures
In most situations surgery involves both breasts and is thus a bilateral procedure. When the cancer has affected one breast, the other breast, still healthy, can be removed in a unilateral preventive mastectomy. Typically, a simple, subcutaneous or nipple-sparing mastectomy is performed. With the former areola and nipple removed, while the other two approaches maintain the nipple area for cosmetic reasons. To improve the viability of the nipple area for preservation during mastectomy, the "nipple delay" procedure can be done several weeks before mastectomy. Reconstructive breast surgery can be performed in the same surgical setting, added after mastectomy. Saline or silicon implants can be used in the rebuilding process and can be placed in later settings.
Preventive mastectomy carries certain risks including anesthesia, bleeding, infection, pain, disorders, anxiety and disappointment.
After surgery, routine screening for breast cancer is recommended.
Alternative
There are other options to reduce the risk of breast cancer in the future. Intensive breast cancer screening for high-risk women can detect treatable early stage cancers. Certain drugs that block the effects of estrogen (ie tamoxifen, raloxifen, exemestane) can reduce the risk by about 50% but also have side effects. Lukpingo-prophylactic oophorectomy reduces estrogen levels and the risk of ovarian and breast cancer; however, the decreased risk of breast cancer is about 50% in high-risk women compared with 90% when preventive mastectomy is performed. Lifestyle changes in weight, diet, exercise, avoiding smoking, limiting alcohol) can reduce risk to some extent.
Reception
The factor that facilitates the decision to undergo a preventative mastectomy is that the results of breast reconstruction surgery have improved. A 2004 Canadian study found that 70% of women were satisfied or very satisfied with reconstruction after bilateral prophylactic mastectomy. In the United States preventive mastectomy gets an increased acceptance. The decisions of famous actresses such as Christina Applegate and Angelina Jolie to undergo preventive mastectomy have provided a broader media attention procedure. The tendency toward prophylactic mastectomy seems less prominent in Europe and India.
References
Source of the article : Wikipedia
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