• Breakthrough Genetics Reference Group
• Understanding breast cancer and risk
• Understanding hereditary breast cancer
• Prevention and treatment
• • Screening from an earlier age
  • Risk-reducing surgery
  • Genetic testing
• Research and trials
• Rights and support

A small number of women at high risk of developing breast cancer decide to have risk-reducing surgery.

A mastectomy is the surgical removal of breast tissue. A mastectomy carried out on both breasts in the absence of breast cancer is known as a risk-reducing or prophylactic bilateral mastectomy.

(Prophylactic refers to the fact that surgery is preventative as it occurs before disease is detected. Bilateral means 'on both sides' and mastectomy means 'breasts are removed'.)

An oophorectomy is surgical removal of the ovaries. The Fallopian tubes are often removed at the same time. An oophorectomy carried out in the absence of ovarian cancer is known as a risk-reducing bilateral oophorectomy or prophylactic bilateral oophorectomy.

(Prophylactic refers to the fact that surgery is preventative as it occurs before disease is detected. Bilateral means 'on both sides' and oophorectomy means 'ovaries are removed'.)

The ovaries and adrenal glands make the hormone oestrogen. Oestrogen is known to encourage breast cancer cells to grow. Removing the ovaries greatly reduces oestrogen production, which may help to prevent breast cancer.

The decrease in risk offered by risk-reducing mastectomy or oophorectomy is always expressed over a period of time. This is because these operations have only been carried out in the last 15 to 20 years or so and their effect on a person's risk over a longer period of time, or lifetime, is not known.

The reductions in risk for women who are at moderate to high risk because of their family history, following different procedures, are given below:

• Following prophylactic mastectomy, the risk reduction
  of breast cancer has been estimated at 90% over 14 years. That is, there is a 90% reduction in breast cancer risk, over 14 years, for women who have a prophylactic mastectomy. This does not mean that the risk is increased after 14 years, there just isn't enough long term evidence of what happens to be sure of the longer term effects yet.


• Following prophylactic oophorectomy, the risk reduction for breast cancer has been estimated at 50% over 9 years. That is, there is a 50% reduction in breast cancer risk, over 9 years, for women who have a prophylactic oophorectomy. This does not mean that the risk is increased after 9 years, there just isn't enough long term evidence of what happens to be sure of the longer term effects yet.


• Following prophylactic oophorectomy, the risk reduction for ovarian cancer has been estimated at over 90% over 8-11 years. That is, there is more than a 90% reduction in ovarian cancer risk, over 8-11 years, for women who have a prophylactic oophorectomy. This does not mean that the risk is increased after 8-11 years, there just isn't enough long term evidence of what happens to be sure of the longer term effects yet.

Risk-reducing mastectomy is available if you have:

• A genetic mutation, found during genetic testing or
• A strong family history of breast cancer, confirmed by a specialist.

Before having a risk-reducing mastectomy you should have the opportunity to discuss the following things with your clinical team:

• The reduction in risk the operation will give.
• Different types of surgery and options.
• Opportunities for breast reconstruction.
• How it may change the way you feel about your body.
• The effects a mastectomy may have on your relationship(s).
• Support groups that you can contact.

Members of the Breakthrough Genetics Reference Group have found it helpful to take a partner or friend to these discussions with them.

This website gives more details on mastectomy and breast reconstruction in women who have developed breast cancer. The procedures are the same for those who choose these options as a risk reducing measure.

Risk-reducing bilateral oophorectomy reduces the risk of both breast and ovarian cancer. If you are at high risk of either of these diseases you can discuss this option with your healthcare professional.

Before having a risk-reducing oophorectomy you should have the opportunity to discuss the following things with your clinical team:

• the reduction in risk the operation will give.
• surgery and options.
• ways of dealing with the symptoms of the early menopause, which results from removal of the ovaries in pre-menopausal women. This should include information about HRT.
  
• how it may change the way you feel about your body.
• the effects an oophorectomy may have on your relationship(s).
• support groups that you can contact.

Members of the Breakthrough Genetics Reference Group have found it helpful to take a partner or friend to these discussions with them.

           

• Breakthrough Genetics Reference Group
• Understanding breast cancer and risk
• Understanding hereditary breast cancer
• Prevention and treatment
• • Screening from an earlier age
  • Risk-reducing surgery
  • Genetic testing
• Research and trials
• Rights and support

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