Preventive Mastectomy (cont.)
3. How effective is preventive mastectomy in preventing or reducing the risk of
breast cancer?
Existing data suggest that preventive mastectomy may significantly reduce (by
about 90 percent) the chance of developing breast cancer in moderate- and
high-risk women. However, no one can be certain that this procedure
will protect an individual woman from breast cancer. Breast tissue is widely
distributed on the chest wall, and can sometimes be found in the armpit, above
the collarbone, and as far down as the abdomen. Because it is impossible for a
surgeon to remove all breast tissue, breast cancer can still develop in the
small amount of remaining tissue
4. What are the possible drawbacks of preventive mastectomy?
Like any other surgery, complications such as bleeding or infection can occur. Preventive mastectomy is irreversible and can have psychological effects on
a woman due to a change in body image and loss of normal breast functions. A woman should discuss her feelings about mastectomy, as well as
alternatives to surgery, with her health care providers. Some women obtain a
second medical opinion to help with the decision.
5. What alternatives to surgery exist for preventing or reducing the risk of
breast cancer?
Doctors do not always agree on the most effective way to manage the care of
women who have a strong family history of breast cancer and/or have other risk
factors for the disease. Some doctors may advise very close monitoring (periodic
mammograms, regular checkups that include a clinical breast examination
performed by a health care professional, and monthly breast self-examinations)
to increase the chance of detecting breast cancer at an early stage. Some
doctors may recommend preventive mastectomy, while others may prescribe
tamoxifen or raloxifene, medications that have been shown to decrease the
chances of getting breast cancer in women at high risk of the disease. (More information about tamoxifen and raloxifene is available in the
National Cancer Institute's (NCI) fact sheets, Tamoxifen: Questions and Answers,
which can be found at
http://www.cancer.gov/cancertopics/factsheet/Therapy/tamoxifen on the Internet,
and The Study of Tamoxifen and Raloxifene (STAR): Questions and Answers, which
can be found at http://www.cancer.gov/newscenter/pressreleases/STARresultsQandA
on the Internet.)
Doctors may also encourage women at high risk to limit their consumption of
alcohol, eat a low-fat diet, engage in regular exercise, and avoid menopausal
hormone use. Although these lifestyle recommendations make sense and are
part of an overall healthy way of living, we do not yet have clear and
convincing proof that they specifically reduce the risk of developing breast
cancer.
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