[Prophylactic breast surgery: The role of DIEP (Deep Inferior Epigastric)]

In France, breast cancer is the most common cancer among women, with 5 to 10% of cases being genetic. Frequently involved genes include BRCA1 and BRCA2, PALB2, TP53, CDH1, and PTEN, among others. Approximately, two in 1000 women carry a BRCA1 or BRCA2 gene mutation. The National Cancer Institute (INCa) provides guidelines for screening and risk-reduction treatments. Prophylactic surgery, including bilateral mastectomy, is a preventive option for high-risk women. Immediate breast reconstruction (IBR), particularly using the DIEP flap technique, helps mitigate the psychological impact of mastectomy, and is part of the gold standard to be offered to patients. This technique uses excess of skin and fat from the lower abdomen and requires micro-surgical skills. Despite logistical challenges, this method is favored for its durability and natural outcome. INCa and other organizations are working to improve access and information for these treatments.