Prophylactic Mastectomy: A boon or bane?

Globally, breast cancer is the second most common cancer next only to lung cancer and a major public health challenge to women’s health. Worldwide, breast cancer affects 1.3 million women every year which represents 23% of all cancers in women. It is estimated that by 2030 the global burden of breast cancer will increase to over 2 million new cases per year. Unlike other cancers, breast cancer is treatable if detected at an early stage. Management of women who carry a high lifetime risk for breast cancer is always an issue of debate. A number of risk-reducing treatment options with varying efficacy exist, including regular surveillance, chemoprevention, and prophylactic surgery. Prophylactic mastectomy (PM) or Risk reducing mastectomy (RRM) remains a controversial procedure as a preventive tool against breast cancer. More women are opting for prophylactic mastectomy as a risk reducing strategy for breast cancer. Prophylactic mastectomy is appropriate only for a small proportion of women who are at high risk for breast cancer. Patient misconceptions about recurrence risk and fear have been implicated in the increase in prophylactic procedures. Other possible reasons for the rise in prophylactic mastectomy are highly sensitive breast cancer screening methods, which diagnose breast cancer at earlier stages, and improved breast reconstruction techniques. With this background this paper aims to analyze the pros and cons of preventive mastectomy.