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“A lot of women who are high risk breast cancer think, “”Oh, the best thing for me to do is to do a risk reduction or prophylactic mastectomy.”” That’s not necessarily the case, and sometimes that’s not even beneficial. The reason being is because to do surgery, which is a risk reduction or prophylactic mastectomy, is what the name implies. It’s a risk reduction. It does not totally eliminate the risk of breast cancer. Most of the surgery that we do is a 95% risk reduction. Some of those patients can still get breast cancer and that’s usually within the skin or some of the tissue that’s surrounding the blood supply, or even in what we call in the axilla or the underarm where there may be some breast cells that may develop cancer one day down the road. So just having a risk reduction surgery or a prophylactic mastectomy doesn’t totally eliminate the risk of breast cancer.
So that’s a conversation you need to have about the risk and benefits because there’s also complications that can happen. And that’s a discussion between you and your breast surgeon that you should have, so that you’re well-informed on the benefits of having risk reduction. Nowadays with 3d mammograms and advanced imaging with MRIs and ultrasounds that we have, high risk monitoring has taken the place of risk reduction surgery. You know, there was a time we call it the Angelina Jolie effect, when patients rushed when they had genetic mutations, that “”I want to be like her, I’m going to reduce my risk.”” And so we had this huge surge of women wanting risk reduction surgery. Now the data that we have now and now with advanced imaging, that effect started to come down, and women are realizing that, “”You know what, I want to keep my natural breasts. I’ll deal with it with high risk monitoring, if it should arise one day.”””
