Surgical Prevention of Breast Cancer

Women with BRCA1/2 gene mutations

Women who test positive for BRCA1/2 gene mutations have a 70-85% lifetime risk of developing breast cancer, and a 20-40% risk of developing ovarian cancer. Such women may elect to undergo prophylactic surgeries, take medications, or receive a combination of medication and surgery as preventive measures. Other genetic mutations can also increase women's risk of breast cancer, but mutations of the BRCA genes are the largest contributors.

Studies show that prophylactic surgery—either mastectomy or ovary removal—has been shown to offer the highest survival benefit. Ovary removal and tamoxifen therapy appears to be the best survival strategy, when quality of life is considered.

Women without BRCA1/2 gene mutations

Women who do not test positive for BRCA1/2 gene mutations but who have an atypia, or an abnormality in the breast tissue, should have clinical breast exams twice or three times per year, mammography once per year, and ultrasound andMRIas recommended by their physicians.

Women who have been treated for breast cancer

Because of the many effective options now available to women with breast cancer, many choose conservative breast surgery (lumpectomy rather than mastectomy) followed by a form of radiation to decrease the risk of local occurrence. Radiation options include therapy directed at the whole breast, which has been the standard of care for 20 years, or for women without BRCA gene mutations, Accelerated Partial Breast Irradiation (APBI).