What is risk-reducing breast surgery?

Risk-reducing breast surgery is an operation to remove healthy breasts to greatly reduce the risk of a breast cancer developing. It is also called risk-reducing mastectomy.

Removing both breasts reduces the risk of getting breast cancer by 90–95%. Although almost all the breast tissue is removed, a very small amount will remain, so there is still a small risk of breast cancer. Experts estimate that after the surgery the chance of developing breast cancer is less than 5% (1 in 20).

Most women have new breast shapes made (breast reconstruction) at the same time as having risk-reducing breast surgery. But some women choose not to. You’ll be able to discuss your options for breast reconstruction with a surgeon. New breast shapes can be made using tissue from another part of your body or with breast implants.

Risk-reducing breast surgery and family history

Risk-reducing breast surgery is only appropriate for a small number of women who are at a high risk of getting breast cancer. A high risk means a 3 in 10 or greater chance of getting breast cancer in your lifetime (30% or greater).

Most women who get breast cancer do not have a family history of it. If you have just one female relative diagnosed with breast cancer over the age of 40, your risk is unlikely to be very different from other women the same age as you. In this situation, risk-reducing breast surgery isn’t usually appropriate. But about 1 in 500 women in the UK (0.2%) have a breast cancer gene mutation that greatly increases their risk of breast cancer.

You may be offered risk-reducing breast surgery if you have:

  • a strong family history of breast and/or ovarian cancer, which usually means several close blood relatives on the same side of the family have had breast cancer or ovarian cancer, often before the age of 50 (close relatives are grandparents, parents, sisters and brothers)
  • had a positive test for any of the main gene mutations (changes) that are linked to an increased risk of breast cancer – BRCA1, BRCA2, TP53, PTEN or the Peutz-Jeghers gene SKT11.

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