Mastectomy

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Breast reconstruction - series

Female breast

Mastectomy: An Illustrated Introduction

Another reason for performing a mastectomy is when a breast contains widespread ductal carcinoma in situ (DCIS). DCIS is a pre-cancerous condition, and has the potential to become invasive cancer if left in place. It is typically discovered when a suspicious mammogram alerts your doctor to perform a biopsy.

DCIS present in a small area can be removed with a lumpectomy, but when spread throughout the entire breast, might require a mastectomy. When mastectomy is done for DCIS, it usually does not require removal of the lymph nodes under the arm.

Prophylactic (preventative) mastectomy is the surgical removal of one or both breasts that do not contain cancer or DCIS. It is done to prevent or reduce the risk of breast cancer, and is considered an alternative to intensive screening. Prophylactic mastectomy should be done only after very careful consideration, which often includes genetic testing and a psychiatric evaluation.

A subcutaneous or a total mastectomy can be done. This surgery is an option to reduce the risk of breast cancer for women at extremely high risk of developing breast cancer.

Women who might consider prophylactic mastectomy include those with a strong family history of breast cancer, especially if relatives are diagnosed at a very early age.

Some families have a known genetic mutation that predisposes to breast cancer (BRCA1 or BRCA2), and individuals can be tested for these genes. Inherited mutations in these genes increase the lifetime risk of developing breast cancer. It is important to note that prophylactic mastectomy greatly reduces, but does not eliminate the risk of breast cancer.

Review Date: 06/07/2006
Reviewed By: J.A. Lee, M.D., Division of Surgery, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.