Q&A: Ask the Doctor

Q: I have a history of benign proliferative breast disease with associated atypical ductal hyperplasia. I have had two needle biopsies and three surgical biopsies in my left breast. I took Tamoxifen for five years and currently am taking Evista. Last year I completed the Myriad My Risk Test resulting in a 37.9% remaining lifetime breast cancer risk. My monitoring plan since 2006 has been alternating diagnostic mammogram and breast MRI. My most recent MRI located an enhancing nodule in my right breast. My oncologist has referred me to a local surgeon to begin the process for prophylactic double mastectomy. I am interested in natural breast reconstruction. I would like to schedule an appointment to discuss my options with your plastic surgeons. I also will need to set up an appointment with the surgeon you use for the actual mastectomy. I am not sure which appointment should be first.

A: Hi Stacy, thank you for contacting us. I am sorry you are having to make very difficult decisions in order to prevent getting breast cancer. I commend you for being very vigilant with screening. As you are aware screening alone won’t prevent breast cancer unless you act on the results of the tests that indicate your risk is high. Many women would consider preventive mastectomy in your situation. For many women knowing that

they can have immediate natural breast reconstruction for a permanent natural result makes the decision a little easier to make. If you feel like you have any amount of extra fatty tissue anywhere on your body then chances are you can use your own natural tissue. I’ll be glad to answer any other specific questions just let me know.

Dr. Craigie

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