Preventive (prophylactic) mastectomy: Surgery to reduce breast cancer risk

Who may consider prophylactic mastectomy to reduce breast cancer risk?

All women are at risk of breast cancer just by being female and advancing in age. But some factors increase your risk significantly.

You may consider prophylactic mastectomy if you have:

  • Already had cancer in one breast. If you need to have one breast removed because of a new cancer diagnosis, and you have a hereditary breast cancer mutation, such as the BRCA1 or BRCA2 mutation, you may decide to have the other, unaffected breast removed at the same time. This prophylactic mastectomy would greatly reduce the possibility of another breast cancer in your lifetime.
  • A family history of breast cancer. If your mother, sister or daughter has had breast cancer, especially if she was diagnosed before age 50, you may be at increased risk. If you have multiple family members — on your mother's or father's side — with breast or ovarian cancer, your risk of breast cancer may be greater.
  • Positive results from gene testing. Genetic testing can identify mutations in genes, such as BRCA1 and BRCA2, that substantially increase your risk of breast or other cancers. If you have a very strong family history of breast cancer, such as relatives with young-onset cancer (younger than 50 years of age) over multiple generations, consider meeting with a genetic counselor to discuss genetic testing. Women of Ashkenazi Jewish descent have a higher incidence of the BRCA1 and BRCA2 mutations.
  • Radiation therapy. If you had radiation therapy to your chest between the ages of 10 and 30, you have an increased risk of developing breast cancer.

Your doctor determines whether you're at high risk of breast cancer based on your risk factors.