Why Choose a Prophylactic Mastectomy?

A prophylactic mastectomy is removal of the glands of a breast that does not knowingly have a focus of cancer
within it.

The choice for a prophylactic mastectomy is difficult and can be categorized most commonly in 5 groups of women:

  1. BRCA positive women patients with a genetic disorder associated with a high risk of developing breast cancer;
  2. BRCA negative women who have a strong family history of breast cancer who participate in a high-risk genetics program with a medical recommendation for prophylactic mastectomy;
  3. BRCA negative young women, typically 35 and younger, with a breast cancer and anxiety regarding the contra-lateral breast;
  4. Older women, typically 65 and older, with a breast cancer who elect for bilateral implant-based reconstruction in order to attain symmetry;
  5. Peri-menapausal women who have undergone mastectomy for cancer and have completed chemotherapy who revisit the concept of prophylactic mastectomy prior to their final stages of breast reconstruction;

Dr. Marga supports your interest and final decision regarding prophylactic mastectomy:

- If you have a strong family history of breast cancer, even if you are BRCA gene negative, we encourage you to discuss your interest in prophylactic mastectomy with Dr. Marga and your cancer care team of physicians.

- If your tumor was NOT seen on screening mammogram or if your breast tissue is so dense making screening mammography difficult, we encourage you to discuss this further with your surgical oncologist and Dr. Marga.

- If you are experiencing anxiety or having trouble sleeping as you worry about the potential development of a contra-lateral breast cancer, we encourage you to seek further information regarding prophylactic mastectomy.

- If you are pre-menapausal and seek to attempt childbirth after the completion of your cancer treatment, we encourage you to maintain your contra-lateral breast for the bonding experience of breastfeeding. Dr. Marga can work with you to include this decision in you reconstructive plan. She has had 3 babies, all girls, born in her practice to date! Prophylactic mastectomy and reconstruction at a later date is possible.

- If nipple-areolar stimulation is a significant component of your intimate life, you may wish to reconsider completing a prophylactic mastectomy as erotic sensation is the final step of breast reconstruction that we have not been able to achieve. A personalized screening protocol including annual MRI scans may be a viable alternative you may wish to discuss with your care team.

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