Breast cancer is the leading cancer-related cause of death for Hispanic women and the second leading cancer-related cause of death for American women of all other races.  In 2007, more than 200,000 American women received a diagnosis of breast cancer as reported by the Centers for Disease Control and Prevention (CDC).  Yet despite this high number of new cases being added to a base of roughly 2.5 million survivors in the US, both the CDC and the American Cancer Society estimate about 40,000 breast-cancer deaths annually with the death rate on a decreasing trend.  The American Cancer Society indicates that the average woman has a 1 in 36 chance of dying from breast cancer, and better if the cancer is detected and treated early.

Who Is At Risk for Breast Cancer?

Research has found that some women—especially those with an extensive family history of breast cancer as well as those who have a harmful mutation in the BRCA1 or BRCA2 genes—have a significantly higher risk of developing breast cancer (i.e., 5 times greater than their counterparts who do not carry these genetic mutations).  It is not inevitable that the presence of BRCA1 and BRCA2 mutations will lead to cancer; however, if a blood test determines that you are carrying one of these, your doctor may bring up the possibility of prophylactic surgery (having an elective double mastectomy in an attempt to prevent breast cancer).  Your doctor may also suggest a prophylactic mastectomy of a healthy breast if the other breast has been affected by cancer.

Will An Elective Mastectomy Reduce Breast Cancer Risk?

According to the Mayo Clinic, undergoing this procedure can lower a high-risk woman’s chances of eventually getting breast cancer by ninety percent.  For every ten high-risk women who opt for prophylactic bilateral mastectomy, only one will eventually be diagnosed with breast cancer.  This occurs because it can be difficult for surgeons to remove all breast tissue, which can be found near the collarbone, abdominal wall, and even armpit.

What Are My Options If I Decide to Have Prophylactic Surgery?

Choosing to remove healthy breasts can be extremely difficult.  Breasts are often psychologically part of a woman’s sense of gender identity; many women have completely normal fears about their appearance (both naked and clothed) and sex life after surgery. Most high-risk women eventually accept that their lives are worth far more than their breasts.  But this doesn’t diminish the emotional aspects of the surgery and recovery.

The good news is that breast reconstruction with saline or silicone implants can be performed immediately following the mastectomy; doing so enables surgeons to use nipple-sparing procedures that help keep a natural look for the breasts.  In a study that was published in July 2008 in Plastic and Reconstructive Surgery, the authors reported that 98% of women who had decided to have prophylactic surgery for breast cancer prevention with a subsequent breast reconstruction surgery were happy with their choice.  The rate was 100% for the subgroup of women who had had a double mastectomy.

If you are faced with this difficult decision, know that you are not alone.  Seek out social support and discuss your options, including breast reconstruction, with your doctor.