Mastectomy is usually recommended when:
Types of Mastectomy
A skin-sparing mastectomy removes the entire breast tissue and may or may not include the nipple and areola. This may involve a total mastectomy that does not remove lymph nodes or a modified radical mastectomy that removes some or all of the underarm lymph nodes.
A nipple-sparing mastectomy is a type of skin-sparing mastectomy that preserves the nipple and areola. This type of mastectomy can be performed for women who:
Mastectomy to reduce inherited risk for breast cancer
The risk for developing breast cancer (and other cancers) is extraordinarily high for individuals who have a strong family history of breast cancer or an inherited mutation in either the BRCA1 or BRCA2 gene.
Prophylactic (preventive) bilateral mastectomy removes healthy breasts to reduce a woman's risk of breast cancer. It is the most effective method of combating a predisposition to the disease: remove most breast tissue and you remove most of the risk. Drastic and irreversible, preventive mastectomy is a deeply personal decision, and an act that is not right for everyone. In previvors (people who have a high hereditary risk of cancer but have not been diagnosed), preventive mastectomy is estimated to reduce breast cancer up to 90%, depending on an individual's personal risk factors. (A small risk remains because it is not possible to eliminate all breast tissue.)
Most women who choose to have their breasts removed to reduce their risk of breast cancer are candidates for nipple-sparing mastectomy that minimizes scarring and often results in no visible scars on the reconstructed breasts. Your own breast skin and nipples can be retained; your breast tissue is replaced with an implant or your own donor tissue.
Although preventive mastectomy is the most effective method of reducing high risk, other options for managing high risk including taking risk-reducing medication or choosing increased surveillance to detect breast cancer in its early stages.