Preventative (prophylactic) mastectomy is surgical removal of the breasts in women who do not have breast cancer.
You may consider having a preventative mastectomy if you have a strong family history of breast cancer and/or if genetic testing suggests a strong likelihood that you may be diagnosed with breast cancer in future. Preventative mastectomy is a big decision. It involves much consideration, consultation with healthcare professionals and genetic counselling.
Most women who have a preventative (prophylactic) mastectomy have both breasts removed (bilateral mastectomy).
Women who decide to have a breast reconstruction after a preventative mastectomy most often choose to have their breast reconstruction at the same time as mastectomy, this is called immediate breast reconstruction. However, you may not feel ready to make such a commitment at the time of your mastectomy. Some women find that factors such as financial issues, family situation or access to services mean that an immediate breast reconstruction is not right for them.
Some women decide that they do not want to have a breast reconstruction. They may choose to have aesthetic flat closure (see information about flat closure after mastectomy). Some people choose to live flat and others choose to use an external breast prostheses (see information about the Services Australia External Breast Prostheses Reimbursement Program).
Having a delayed breast reconstruction at any time after you have had a mastectomy is called delayed breast reconstruction, is always an option later if you change your mind.
If you choose to have a mastectomy without breast reconstruction, the surgeon will remove the breast skin, areola and nipple. If you decide to have a breast reconstruction later, the remaining skin may need to be stretched to accommodate a breast shape. Alternatively, skin and tissue from another part of the body
can be used to replace the skin that has been removed surgically.
Physical appearance following preventative mastectomy
If you are having a preventative (prophylactic) mastectomy, it is usually possible to preserve the skin over the breast, the areola and the nipple. Breast reconstruction following preventative mastectomy will usually involve replacing the underlying tissue only. This means that the reconstructed breasts are likely to look similar to the original breasts. There may be some differences in shape and feel, depending on the type of breast reconstruction. Having both breasts reconstructed means they are more likely to be symmetrical.
