Preventive Mastectomy (cont.)
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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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