Surgery to reduce the risk of breast cancer

Information for the public

If you are at high risk of developing breast cancer or you have had breast cancer, risk-reducing surgery might be an option. This is called a risk-reducing bilateral mastectomy. The surgery involves removing as much healthy tissue as possible from both breasts. This operation greatly reduces, but does not completely remove, the risk of breast cancer in the future.

Before you make any decisions about risk-reducing mastectomy, you should be referred for genetic counselling. Discussion of your options for reducing risk should include all the possible benefits and risks of risk-reducing mastectomy. These include the likely reduction in the risk of breast cancer and the effects of mastectomy on your body image and your sexual relationship with your partner.

If you are considering risk-reducing mastectomy you should be able to discuss your options for breast reconstruction (rebuilding) with experienced surgeons before the operation. They should tell you how they can rebuild your breasts using tissue from another part of your body or synthetic 'implants'. Breast reconstruction can be done as part of the mastectomy or at a later date. The surgeons should make sure that you know that your breasts may have a very different appearance and feel after reconstruction surgery.

Breast tissue that is removed during mastectomy will be examined after the operation for signs of cancer. Before the operation your healthcare professional should discuss with you the possibility that cancer might be detected in the breast tissue that has been removed.

If you are thinking about risk-reducing mastectomy, you should be given details of support groups where you can talk to other women who have already had the operation.

Surgery to reduce risk isn't suitable for everyone. It may not be an option if you have other conditions (for example, a heart condition) that would increase the risk of surgery. You will still be able to have surveillance even if you decide against surgery or surgery isn't suitable for you. This will help to ensure that any new cancer is picked up early. The breast cancer team will support you throughout the surveillance programme.