Mastectomy Options

A risk-reducing mastectomy, also called a prophylactic mastectomy, is a surgery performed to lower the risk of developing breast cancer. Unlike therapeutic mastectomy (done to treat existing cancer), this surgery is preventive. It is most often considered by women who carry a high-risk genetic mutation (such as BRCA1 or BRCA2) or who have a strong family history of breast cancer.

How It Works

During a prophylactic mastectomy:

• One or both breasts are removed, even though cancer is not currently present.

• The procedure may be skin-sparing, nipple-sparing, or areola-sparing, depending on your body and preferences.

• Reconstruction with implants or natural tissue can often be performed at the same time, or you may choose a flat closure.

By removing most of the breast tissue, this surgery greatly lowers—but does not completely eliminate—the risk of breast cancer.

Who May Be a Candidate

A risk-reducing mastectomy may be recommended if you:

• Carry a BRCA1, BRCA2, or other high-risk genetic mutation.

• Have a strong family history of breast or ovarian cancer.

• Had chest radiation therapy at a young age, which increases lifetime risk.

• Have certain conditions (like lobular carcinoma in situ, or LCIS) combined with other risk factors.

Your doctor may suggest genetic testing, imaging, and counseling before making this decision.

Benefits of Prophylactic Mastectomy

• Major reduction in risk: Can lower the chance of developing breast cancer by up to **90–95%** in women with BRCA mutations.

• Peace of mind: Many women feel relief knowing they’ve taken a big step to lower their risk.

• Immediate reconstruction option: Many women combine prophylactic mastectomy with reconstruction, so they wake up with a breast shape in place.

Things to Keep in Mind

• Not a guarantee: No surgery can remove 100% of breast tissue, so a small risk of breast cancer remains.

• Major surgery: Like all mastectomies, recovery involves healing, scars, and potential complications.

• Emotional impact: Losing breasts preventively can bring complex feelings, even when the choice feels right.

• Other risk-reducing steps: Some women combine surgery with medication or increased screening for the best overall protection.

Emotional Considerations

Choosing a prophylactic mastectomy can feel empowering for women at high risk—but it can also feel overwhelming. Some women feel relief, while others grieve the loss of their breasts or struggle with body image changes. Both reactions are normal. Talking with others who’ve been through the decision, joining support groups, or connecting with mentors can help.

A Personal Choice

Risk-reducing mastectomy is about taking control of your health and future. For women with a strong family history or genetic risk, it may provide peace of mind and a sense of empowerment. For others, careful monitoring and screening may feel like the right path.