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Bilateral prophylactic mastectomy: issues and concerns

M E Stefanek1

  • 1Johns Hopkins University School of Medicine, Johns Hopkins Oncology Center, Baltimore, Md., USA.

Journal of the National Cancer Institute. Monographs
|January 1, 1995
PubMed
Summary

Prophylactic mastectomy is a controversial option for women at high risk of breast cancer, especially those with BRCA1 mutations. Further research is needed on its effectiveness and patient perceptions.

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Area of Science:

  • Oncology
  • Genetics
  • Public Health

Background:

  • Managing women at high risk for breast cancer presents a clinical challenge.
  • Options include prophylactic mastectomy versus intensive surveillance (mammography, physical exams, self-exams).
  • Discovery of the BRCA1 gene and associated mutations complicates management decisions.

Purpose of the Study:

  • To investigate healthcare provider and patient perceptions of bilateral prophylactic mastectomy.
  • To address remaining research questions on the efficacy and utilization of this procedure.
  • To consider women with strong family histories who decline genetic testing.

Main Methods:

  • Preliminary studies on perceptions of bilateral prophylactic mastectomy.
  • Review of existing literature on prophylactic mastectomy versus surveillance.
  • Analysis of clinical dilemmas in high-risk breast cancer management.

Main Results:

  • Preliminary studies explored provider and patient views on prophylactic mastectomy.
  • Significant research questions persist regarding the procedure's efficacy and use.
  • Women with BRCA1 mutations face an estimated 85% lifetime breast cancer risk.

Conclusions:

  • Bilateral prophylactic mastectomy remains a complex consideration for high-risk women.
  • Understanding patient and provider perceptions is crucial for informed decision-making.
  • Further research is essential to clarify the role of prophylactic mastectomy in breast cancer prevention strategies.

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