Bilateral Risk-Reducing Prophylactic Mastectomies in an Unaffected BRCA1 Carrier Using Dermal Sling and Implant

Hereditary breast cancer (HBC) accounts for 5-10% of all breast cancer patients. Mutations in BRCA 1 and 2 are the most common culprits of HBC. These patients have a much higher lifetime risk of developing breast cancer than the non-carriers. Thus these high-risk patients qualify to receive risk-reducing measures in form of close surveillance, chemoprophylaxis, or sometimes even risk-reducing surgeries in high penetrance mutation carriers. We report a case of bilateral risk-reducing prophylactic mastectomies (B/L RRM) and bilateral risk-reducing salpingo-oophorectomy (B/L RRSO) performed in a 37-year-old healthy BRCA 1 carrier. Although, this is an age-old practice, its acceptance in India has been low for reasons such as cost of surgery, social stigma, lack of awareness, fear of visiting an oncology clinic, surgery and reconstruction, or loss of a healthy organ; and more acceptance towards other risk reduction methods.