Making a decision about risk reducing breast surgery

When you are thinking about risk-reducing breast surgery, you will be supported by a team of specialists. They can answer your questions and give you the information, support and counselling you need. They are called a multidisciplinary team (MDT).

You will have several appointments with different healthcare professionals. They will talk to you about:

• your risk of breast cancer
• the different options for managing or reducing your risk
• whether clinical trials or preventative hormone medication might be another option
• what risk-reducing breast surgery involves
• your options for breast reconstruction surgery
• your feelings about the surgery and how it may affect you and your relationships.

This usually takes several months. This may sound like a long time. But it is important to take your time and make an informed decision.

The following healthcare professionals will support you while you make your decision:

If you decide to have risk-reducing breast surgery, the wait for surgery is likely to be about 12 to 18 months.

It might be helpful to take notes at appointments to remember what has been said. It may also help to write a list of the advantages and disadvantages of having surgery.

• The operation greatly reduces your risk of developing breast cancer.
• It aims to avoid the need for cancer treatments such as radiotherapy and chemotherapy, and potential side effects.
• After the operation, you may feel much less anxious about getting breast cancer and the impact it could have on your life.
• You will not need to have breast screening.

• It can take up to 6 months or more to fully recover after the operation.
• As with all operations, there can be complications. The results of the surgery are permanent.
• Your body will not look the same as before. You may be unhappy with the change in your appearance.
• If you are also having breast reconstruction surgery, you are likely to need more than 1 operation to get the best cosmetic result.
• If you decide to have breast reconstruction surgery, the reconstructed breasts will not have the same feeling or sensation.
• There will be numbness or a change in sensation.
• You may feel less confident sexually.
• You will not be able to breastfeed.

You will need time to explore your feelings about having risk-reducing breast surgery and having your breasts removed. This is important even if you have already decided you want to have the operation. You may have strong emotions after the operation. Taking time to think about how you feel can help you prepare.

If you have a partner, talking with them about your feelings, worries or concerns can help. If you and your partner might find it difficult to talk about how you feel, speak to your breast care nurse, counsellor or psychologist for advice.

People may react in different ways when you tell them you are thinking about having risk-reducing breast surgery. This can be difficult to deal with. It is important you focus on what is important to you. A psychologist or a breast care nurse can help you to do this.

You may want to consider the following things:

• How anxious do you feel about the possibility of getting breast cancer?
• If you have an experience of cancer in your family, how is it affecting your decision?
• What do your breasts mean to you?
• How would having your breasts removed affect you feel about yourself and your confidence?
• If you have a partner, do you know each other’s feelings and concerns about the surgery?
• If you are not in a relationship, are you worried the surgery may affect how you feel about future relationships? Are other people in your life affecting your decision?
• If you are thinking about having breast reconstruction, have you thought about what your breasts will look and feel like afterwards?
• What are your feelings about other options instead of surgery?

Take as much time as you need to make your decision.