Family History: Should I Consider A Preventive Mastectomy?

Ask the DoctorThis week, Dr. Richard Kline and Dr. James Craigie of The Center for Natural Breast Reconstruction answer your questions.

Q: I was diagnosed with stage 3 breast cancer about 3 years ago. I underwent all the usual treatments since then; however my oncologist has moved to another state, leaving me without one! I have not been able to get the reconstruction process completed.The last time I spoke with my oncologist, I was informed that it couldn’t be done. Do you think you can help?

A: Thanks for your inquiry!

Without knowing more details I can’t answer your question with certainty, but only rarely do we encounter a patient who can’t be reconstructed by any means. If you would like, we can have our nurse or PA call you to get more details.

 Dr. Richard M. Kline, Jr.

 

Q: My doctor recently told me that based on my family history–mom with a bilateral mastectomy, aunt (on mom’s side) with bilateral mastectomy, and another aunt (on mom’s side) with partial mastectomy–and combined with my PTEN mutation, thyroid issue, and other auto immune illnesses, that my chances of getting breast cancer in the next three years is 1 in 3. Should I seriously consider getting a preventive mastectomy?

A: A preventive mastectomy is the most effective way women can reduce their risk for breast cancer.

Close screenings with exams and x-rays or MRI, will only help with early detection and do not lower the chances of getting breast cancer. Women who are at high risk for breast cancer because of many different factors, family history or known genetic mutations do have preventive mastectomies to lower their chances. Before considering this big step you should review your risks with someone familiar with preventive mastectomies or a specialists in genetics.

It sounds like you have a doctor helping you through this decision. When it comes to proceeding further you should look for a team with a surgeon specializing in the breast removal and one specializing in rebuilding the breast at the same time as the mastectomy. Preventive mastectomies can preserve the breast skin and nipple, and are very different from most other types of mastectomy. Also the reconstructive procedures are specific for preventive mastectomies and have the chance to be the most natural results.

Our practice specializes in this type of breast reconstruction and we work with specialists who regularly perform nipple-sparing mastectomy. If you want more information we can contact you with a few more questions. Regarding my recommendation about when or if to do it I would say it is a very individualized decision to make, and the process is major surgery. You should know about all the risks and know what to expect regarding possible results.

We would be glad to review the details with you if you like. If so just let us know and I will have our PA or RN give you a call to discuss the details. I hope this helps.

Dr. James Craigie

Center for Natural Breast Reconstruction

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!

Dealing with Juvenile Papillomatosis: Should I Have a Risk-Reduction Mastectomy?

 The following question is answered by Dr.James Craigie of The Center for Natural Breast Reconstruction.

 

 I am getting antsy with my breast health and am concerned for my future cancer risk. I have been diagnosed with juvenile papillomatosis, and have had one benign breast lump removed.

I currently have one lymph node and 5 masses (bilateral) under watch by mammogram/ultrasound every 6 months. I am really considering a prophylactic mastectomy due to my young age (39).

What are your thoughts, and would you recommend this if I were your patient? Also, do you think insurance would cover it in my case?

 

Thank you for your question. Do you have any family members who have had breast or ovarian cancer? Even if the answer is no, some people would consider a risk reduction mastectomy and immediate reconstruction. Multiple papillomas may increase your chance for breast cancer. Frequent screening with exams, ultrasounds mammograms will not prevent cancer. The idea of screening is to find something early.

If you are undergoing high risk surveillance (it seems that you are with all those repeat exams) then you should at least have the conversation with a breast surgeon who has experience with that type of surgery.  

My expertise is in breast reconstruction and one area that we specialize in is breast reconstruction immediately at the time that someone has preventive mastectomy to reduce their chances of developing breast cancer. We work with an expert breast surgeon who performs the mastectomy but preserves the breast skin and nipple. Mastectomy for preventive reasons is very different from mastectomy when cancer has already developed. The reconstruction is different in that we can usually get the best possible result under those circumstances.

I hope I have answered your question please let me know.

–Dr. James Craigie

Center for Natural Breast Reconstruction

 

 Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!