A mastectomy is the removal of a breast when there is breast cancer present. A bilateral mastectomy means that both breasts are removed. Some women who have learned that they carry the breast cancer gene opt for prophylactic bilateral mastectomy.
Prophylactic means a preventive measure. The word stems from the Greek term “an advance guard.” Prophylactic measures are taken to ward off an unwanted consequence or disease, such as breast cancer. Most women are not diagnosed with breast cancer in both breasts at the same time. When a woman chooses to remove both breasts simultaneously, it is generally because she has had breast cancer in one breast and decides to take preventive measures and remove the other breast or she has been diagnosed with the breast cancer gene.
When a bilateral prophylactic mastectomy is performed, all of the breast tissue, or as much as possible, is removed. The objective is to prevent breast cancer from occurring or, in some cases, reoccurring.
The glandular tissues located under the skin are removed but the skin is conserved so that reconstruction can take place, which is done by a plastic surgeon. The missing tissue can be replaced with tissue from the patient’s lower abdominal area or a salt water (saline) implant, according to CBSnews.com.
It is impossible for a surgeon to remove every bit of tissue, according to The Early Show's Dr. Michael Osborne, chief of breast service at New York Hospital-Cornell Medical Center, although every effort is made to get as much tissue as possible. Residual breast tissue that is left behind has a small risk of becoming cancerous.
Women who undergo bilateral mastectomies generally fall into one of two groups: The first group consists of those women who have had breast cancer in one breast and choose to remove the other breast as a preventive measure. This is referred to as contralateral prophylactic mastectomy. The other group consists of those women who are at high risk, based on their family history, as well as genetic testing, of getting breast cancer. Genetic testing can show if a woman is carrying BRCA2 or BRCA1, the so-called breast cancer genes. Women who do have these genes have a huge change of getting breast cancer; in fact, as much as an 85 percent chance. Some women who opt for bilateral mastectomies are those who have a debilitating fear of developing breast cancer.
Bilateral mastectomies are highly effective when it comes to preventing breast cancer, although there is no 100 percent guarantee. The risk reduction is in the vicinity of 98 to 99 percent.
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