prophylactic (PRO-fih-LAK-tik) mastectomy is the removal of both breasts to
prevent breast cancer. Studies suggest prophylactic bilateral mastectomy can
lower the risk of breast cancer in women at high risk by at least 90 percent [246,248-252].
Some BRCA1 or BRCA2 mutation carriers and women with a strong family
history may choose this option to ease worries about getting breast cancer. It
may make them feel they have done all they can do to lower their risk of breast
at high risk for breast cancer should talk with her health care provider about
the pros and cons of prophylactic mastectomy. Prophylactic mastectomy does not
completely protect a woman from breast cancer [251-252].
A mastectomy is not able to remove all of a woman's breast tissue. This means
there is always a small chance breast cancer could occur in the remaining
The benefits of prophylactic mastectomy seem to be greatest in
younger women. Younger women have more years of life ahead than older women. For
a 30-year old woman who has a BRCA1 or BRCA2 gene mutation,
the procedure may add three to five years to her lifespan [249,253-254]. For women 60
years and older, the gain in lifespan after a prophylactic mastectomy is small.
Prophylactic mastectomy has some risks, including problems (such as
infection) from surgery. And, in addition to the emotional impact of losing both
breasts, some women have body image issues that can affect how they feel
Talking with a health care provider or counselor, or joining a support group,
can help address these issues.
Learn more about sexuality and
intimacy after breast surgery.
Learn more about support groups.
If you choose to have a
prophylactic mastectomy, you may wish to have breast reconstruction at the same
time as the mastectomy or at a later time.
Learn more about breast reconstruction.
At this time, no federal laws require insurance
providers to cover prophylactic mastectomy. Some states do have a law requiring
coverage for prophylactic mastectomy, but coverage varies state to state.
It is best to check with your insurance provider to learn about your plan’s
* Please note, the information
provided within Komen Perspectives articles is current as of the date of
posting. Therefore, some information may be out of date at this time.
Women with a BRCA1 or
BRCA2 gene mutation are at higher risk of both breast cancer and
ovarian cancer. One option for reducing these risks is prophylactic oophorectomy
(surgical removal of the ovaries). This procedure [246,253,255-260]:
The National Comprehensive Cancer
Network (NCCN) recommends women from families with hereditary ovarian cancer
syndromes, including BRCA1/2 carriers, have oophorectomy between ages
35 and 40 (or after childbearing is complete) .
Some support groups are tailored for BRCA1/2 mutation carriers
and those with BRCA-related cancers. Our Support section offers a
list of resources to help find a local or online support group.
For example, FORCE
and Sharsheret are organizations that have on-line support for
women affected by hereditary breast and/or ovarian cancer.
Facts for Life: Prophylactic Mastectomy
Facts for Life: Breast Reconstruction & Prosthesis