Is prophylactic mastectomy recommended in cases of women who have a family history of breast cancer?
I have a strong family history of breast cancer – two of my aunts and my mother had it. Would you recommend a mastectomy even though I have not been diagnosed with breast cancer?
I would strongly suggest genetic counselling and getting yourself checked for hereditary breast cancer based on your family history. But before that I usually advise that my patients have medical and hospitalisation insurance sorted for yourself and your family members.
Even with such a strong family history, it is not given that you may be carrying genes that increase your risk of breast cancer.
Prophylactic mastectomy ( mastectomy before diagnosis of breast cancer) is an option for those who are carrying genes that put them at very high risk of having breast cancer e.g. BRCA gene mutation. Close surveillance is the other option.
The clear cut advantage for a prophylactic mastectomy is reduction in worry about breast cancer and NOT breast cancer survival. So this is something that needs a lot more discussion with your doctor. I generally go through the options of either with my patients. It is a long consultation and usually more than one before a decision for a prophylactic mastectomy is made. Then, very often, there are more consultations about reconstruction as the same studies that report on the efficacy of prophylactic mastectomies also report about the negative impact on cosmetic result and sexuality if no reconstruction was performed.
All in all, careful consideration and some tests need to be done before a mastectomy should be considered.
Thank you for the question and best wishes.