Why consider having risk-reducing breast surgery?

The options other than surgery include:

Regular breast screening Back to top

This involves regular mammography (breast x-rays) and/or MRI scans (scans that use a magnetic field to build up a picture of the breasts).

Regular breast screening can help to find breast cancer at an early stage, but it won’t prevent it. Breast cancers found at an early stage are often curable.

The UK’s National Institute for Health and Clinical Excellence (NICE) is an independent body that gives guidance to doctors on the prevention and treatment of ill health. NICE’s Familial Breast Cancer Guideline recommends that women are offered yearly mammograms if they are aged 40–49 and have an increased risk of developing breast cancer.

The guideline also recommends that MRI scans should be available to some women under the age of 50 who are at increased risk of developing breast cancer, depending on their family history and level of risk.

To find out more about early detection and screening, you may find it helpful to read our information about breast screening|.

Taking part in research trials Back to top

There are trials looking into whether drugs such as tamoxifen, anastrozole (Arimidex®) or raloxifene (Evista®) can reduce the risk of developing breast cancer. However, some of these trials| may not be suitable for all women. 

So far, a drug that will reliably prevent breast cancer without causing too many side effects has not been found. However, research is continuing and it’s certainly worth discussing the benefits and disadvantages of taking part in some research with your doctors.

Risk-reducing breast surgery Back to top

National UK guidance on familial breast cancer (breast cancer that runs in families) says that surgery to reduce the risk of breast cancer is only appropriate for a small number of women who are from families that have a high risk of developing breast cancer.

The guidance also states that women having risk-reducing breast surgery should be managed by a team of health professionals called a multidisciplinary team (MDT), that consists of all or some of the different healthcare professionals.

Women who may wish to think about having this type of surgery include those:

• with a strong family history of breast cancer – especially if the breast cancer was diagnosed among several close blood relatives on the same side of the family (such as grandmother, mother or sisters) and before the age of 50
• who have a positive test for either of the BRCA gene mutations/changes
• who have already had breast cancer and have a high risk of developing breast cancer in the other breast
• who are at increased risk of breast cancer and also have breast microcalcifications (tiny calcium deposits), or have very dense breast tissue, which makes it difficult to detect breast cancer with mammography.

Risk-reducing mastectomy and breast cancer risk Back to top

It’s important to remember that not all women who have an increased risk of developing breast cancer will actually develop it. Some women who choose to have risk-reducing breast surgery may never have developed breast cancer. However, there is currently no way of knowing whether an individual woman will develop breast cancer or not. For some women, having risk-reducing breast surgery helps to relieve their anxiety and lessen their fears of developing breast cancer.

It is impossible for surgeons to remove every single breast cell during a mastectomy, and this depends to some extent on the type of mastectomy| that is done. Usually about 90–95% of the breast tissue is removed. Because some of the breast tissue is left behind after surgery, risk-reducing mastectomy won’t completely remove the risk of developing breast cancer.

Research has shown that bilateral risk-reducing mastectomy can reduce the risk of breast cancer, in women who have mutations in the BRCA1 and BRCA2 genes, by as much as 90% (9 in 10). So, although the surgery doesn’t completely get rid of the risk it does significantly reduce it.

Some experts believe that the chance of developing breast cancer after total mastectomy or skin-sparing mastectomy| is actually less than 10% (1 in 10). This means that after having a risk-reducing mastectomy, a woman’s chance of developing breast cancer may actually be less than that of a woman in the general population.