Who Should Get A Risk Reduction Mastectomy?

Who Should Get A Risk Reduction Mastectomy?

December 14, 2021
Everett Bonner, MD
Everett Bonner, MD

Breast Surgery



The data shows that risk reduction of prophylactic mastectomies is not always the best course of action, especially with a lot of our imaging and a lot of our technology that we have today. But there are some cases where we do recommend that as a society and as breast cancer surgeons, and the data shows that these patients may benefit from that.


If you have a patient who has a diagnosis of breast cancer, or who has a diagnosis of a high-risk lesion, whether that’s atypical ductal hyperplasia, what we call ADH, or DCIS or patient who has lobular carcinoma in situ, we may recommend taking care of the cancer side, or if it’s one of the high risk lesions, that maybe you may want to consider a risk reduction surgery to lower that risk. But those are usually the only times that we recommend doing risk reduction or prophylactic surgery.


There are a few small patients that have such dense breasts or multiple lesions within their breasts, which are all benign, but may hinder accurate diagnosis of a cancer because of the masking of these lesions or because of the distortion of some of these benign processes have had. And maybe some of those patients may want to consider that, especially if they’re a BRCA1 or 2 mutation, but that’s another discussion you need to have with your breast surgeon to see if that’s the right procedure for you.


Key Takeaways

1. There are some cases risk reduction or prophylactic mastectomies are recommended.

2. A patient who has a high-risk lesion might want to consider it to lower that risk.

3. There are a few patients who have such dense breasts that diagnosis might not be accurate, they might consider it.