What is risk-reducing breast surgery?

Some women have an operation to remove healthy breasts and reduce their risk of breast cancer. This is called a risk-reducing mastectomy and there are different types of surgery. Breast reconstruction to make new breast shapes is often done at the same time.

Risk-reducing mastectomy is only suitable for some women with a high risk of developing breast cancer. You may be considering it if you have:

  • a strong family history of breast or ovarian cancer
  • tested positive for a gene change that greatly increases your risk, such as BRCA1 BRCA2, PTEN or TP53
  • had breast cancer and have a high risk of developing a new breast cancer in the other breast.

A genetic specialist or genetic counsellor will talk to you about your risk of developing breast cancer. They can explain possible ways to manage your risk.

Deciding whether to have risk-reducing breast surgery is a personal decision, every woman’s situation is different.

The breasts

Breasts are made up of fat, supportive (connective) tissue and glandular tissue containing lobes. The lobes (milk glands) are where breast milk is made. They connect to the nipple by a network of fine tubes called ducts.

Breast side view
Breast side view

View a large version

Read a description of this image

Types of risk-reducing breast surgery

Bilateral risk-reducing mastectomy

Bilateral risk-reducing mastectomy is the surgical removal of both breasts to help reduce the risk of developing breast cancer. It’s different from a mastectomy that’s carried out as part of cancer treatment. Bilateral risk-reducing surgery is carried out even though there is no evidence of cancer in the breasts.

Contralateral mastectomy

Women with a strong family history of breast cancer and who have cancer in one breast sometimes decide to have the other breast removed to reduce the chance of getting breast cancer again. This is called contralateral mastectomy.

This information is mainly about bilateral risk-reducing mastectomy, although much of it will be relevant if you are considering having contralateral mastectomy.

Breast reconstruction

Risk-reducing mastectomy can usually be followed by breast reconstruction (the formation of new breast shapes). This can be done either during the same operation (immediate reconstruction) or at a later date (delayed reconstruction). This is optional – not everyone who decides to have risk-reducing mastectomy will want to have breast reconstruction.

Family history and risk-reducing breast surgery

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. These women are from families that have a very high risk of developing breast cancer.

You may wish to think about having this type of surgery if you have:

  • a strong family history of breast and/or ovarian cancer – especially if 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
  • had a positive test for any of the main gene mutations (changes) that are linked to an increased risk of breast cancer - BRCA 1 or BRCA 2 or the rarer TP53 or PTEN
  • already had breast cancer and have a high risk of developing breast cancer in the other breast.

You may find it helpful to read our information about cancer genetics, which explains how specific genes are sometimes involved in the development of certain cancers. It also describes the support and information you can get from your local family cancer clinic.

At your local family cancer clinic a genetic specialist, or genetic counsellor, will be able to discuss your risk of developing breast cancer. They can also talk about ways in which you may be able to reduce or manage this risk.

Back to Risk-reducing breast surgery

What happens after surgery?

Recovery can take some time after risk-reducing breast surgery. It will depend on the type of surgery you have had.