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Prophylactic mastectomy to reduce risk?

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Question from LMG: I am 39, BRCA1 positive, and currently undergoing MRI surveillance every six months. My 47-year-old sister died of breast cancer last month. Am I being foolish not to have prophylactic removal of my breasts? I had my ovaries out at 36 to reduce risk already. Should I start tamoxifen?
Answers - Beth Baughman DuPree, M.D., F.A.C.S. The decision to do prophylactic surgery is often a very difficult decision to make. Prophylactic mastectomy does not remove all risk of developing breast cancer but can significantly reduce the risk of developing an invasive cancer in the future.

A very thorough discussion should take place between you the patient, your surgeon and potentially your oncologist to help you come to a decision about what is absolutely best for you. There is no right or wrong answer, and depending upon what your goals are through this process you should be able to come up with a plan of action for your future surveillance and/or risk reduction.

Tamoxifen can certainly help to decrease the risk of developing an estrogen-receptor-positive tumor, but there are no foolproof methods to keep you from developing a breast cancer. Therefore, as I said before, work with your physician to determine what is best for you.
Lynn Hartmann Issues that can help with this decision include the ease of your breast exam and the density of your breast tissue. Having had your ovaries removed should provide some risk reduction. I would reiterate what Dr. DuPree has said, that this is very much an individual decision.

This Ask-the-Expert Online Conference called Risk Reduction featured Beth Baughman DuPree, M.D., F.A.C.S. and Lynn Hartmann answering your questions about breast cancer risk factors and ways to lower your risk.

Editor's Note: This conference took place in February 2006.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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