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CancerQuest > Introduction to Patient Information > Introduction to Cancer by Type > Breast Cancer: Introduction > Prophylactic Mastectomy, BCT, and Mastectomy

Prophylactic Mastectomy, BCT, and Mastectomy

Prophylactic Mastectomy

A prophylactic mastectomy can be carried out for persons at risk for developing breast cancer. An estimated 4-7% of all breast cancers are hereditary. The most well known inherited gene mutation in BRCA1 and BRCA2 significantly increases the lifetime risk for breast cancer. A prophylactic mastectomy is the most effective method of risk reduction in high risk women. The risk of newly formed breast cancer after a prophylactic mastectomy is small.⁽¹⁾

Breast-conserving Operation (also called Breast Conservation Therapy or BCT) vs. Mastectomy

An alternative to a radical mastectomy for early stage breast cancer is breast conservation therapy. Breast conservation therapy includes lumpectomy, axillary lymph node dissection, and, usually, radiation therapy. The therapy has two goals: 1) to reduce the risk of cancer reoccurrence, and 2) to preserve the breast anatomy as best as possible.

A 22 year study of breast cancer survivors compared mastectomy to breast conservation therapy. All women in the study had been diagnosed with stage I or II breast carcinoma. Both overall survival and disease-free survival showed little difference between the two groups.⁽²⁾

Axillary Lymph Node Dissection

Axillary lymph node dissection is carried out with breast-conserving therapy for early stage breast cancers. It is the current standard of surgical care to reduce morbidity of axillary recurrence. The purpose of this procedure is to eliminate any cancer cells that may be residing in these lymph nodes. The risks for this procedure include infection, cutaneous numbness, long-term postoperative dysthesias and significant lymphedema.⁽³⁾

References for this page:

1. Isern AE, Loman N, Malina J, Olsson H, Ringberg A. "Histopathological findings and follow-up after prophylactic mastectomy and immediate breast reconstruction in 100 women from families with hereditary breast cancer." Eur J Surg Oncol. 2008 Apr 21. [PUBMED]
2. Poggi MM, Danforth DN, Sciuto LC, Smith SL, Steinberg SM, Liewehr DJ, Menard C, Lippman ME, Lichter AS, Altemus RM. "Eighteen-Year Results in the Treatment of Early Breast Carcinoma with Mastectomy versus Breast Conservation Therapy:the National Cancer Institute Randomized Trial." Cancer. 2003 Aug 15;98(4):697-702. [PUBMED]
3. McCready D, Holloway C, Shelley W, Down N, Robinson P, Sinclair S, Mirsky D. "Surgical management of early stage invasive breast cancer: a practice guideline." Can J Surg. 2005 Jun;48(3):185-94. [PUBMED]