For whom is the procedure suitable?
The term prophylactic mastectomy refers to the removal of the mammary gland preventively, before the onset of breast cancer, which is accompanied by simultaneous rehabilitation. This method has become very popular in recent years, mainly because with genital control it is now possible to identify women who belong to the high-risk group. The technique became even more known to the general public, with the publication of the case of Angelina Jolie, who underwent a prophylactic mastectomy bilateral with immediate restoration.
It has been found that there are specific mutations of genetic material that are heritable and which lead to some forms of cancer. Such genes are BRCA1 and BRCA2 (Breast Cancer) and more rarely PALB and BRD7. The first two are associated with a high probability of breast and ovarian cancer, compared to women who do not have these genes. If the test is positive, a prophylactic mastectomy with immediate restoration is recommended. Also, women with a burdened family history are recommended to undergo prophylactic mastectomy after childbearing, even when the gene is negative. Finally, in cases of proven carcinophobia, surgery can be performed.
Immediate restoration and safety. Suitable for women with BRCA positive.
Prophylactic mastectomy techniques
During prophylactic mastectomy, the operation is planned based on the aesthetic result, always following the oncological criteria. The decision to maintain or not to maintain the nipple is made after discussion but also based on the anatomical particularities of each breast. The incision is made either under the breast or near the nipple, but variations of techniques may be needed to correct problems such as excessive sagging or excessively large breasts. From these incisions, a total removal of the mammary gland is performed, which is sent for histological investigation.
Then the appropriate silicone implant is selected, depending on the size of the breast and the desired result. The implant is placed under the major pectoral muscle, in order to have better coverage. In some cases, it is necessary to use supporting materials such as mesh or xenogenic materials, in order to better support the implant at the lower pole.
The drains are removed the next day and the duration of stay in the clinic is 1-2 days. In cases where the nipple is preserved, the result is immediate. If the nipple is also removed, the nipple is reconstructed in a second year, usually 3-6 months later.
Prophylactic mastectomy results
The final result becomes apparent after 2-3 months, after the edema in the area has settled. Taking into account that mastectomy planning is based on the final result, we have the best conditions for the outcome of the aesthetic result.