Can I Get a Preventative Mastectomy?

Young woman looking in the mirror thinking about if she can get a preventative mastectomy

If you’re reading this blog, you’re probably wondering what a preventative mastectomy is or considering the question, “Can I get a preventative mastectomy?” In this post, you’ll find the answers to most of your questions, plus resources for further information. If you’re ready to talk about getting a preventative mastectomy, Contact Harris Plastic Surgery to discuss your options today.

A preventative mastectomy (also called a prophylactic mastectomy) is a surgical procedure where high-risk individuals have one or more breasts removed to reduce the risk of developing breast cancer later in life. You may also coordinate reconstructive surgery immediately following a preventative mastectomy during the same surgical procedure to maintain your appearance and reduce your lifetime risk of developing cancer.

Below, I’ll answer some of the most common questions about getting a preventative mastectomy, what that means, what your options are, who to talk to, and some insurance basics.

Who Should Consider Getting a Preventative Mastectomy?

Preventative mastectomy is a medically necessary surgery for some people, but not everyone. Individuals who are good candidates for preventative mastectomy are those who have:

  • BRCA1 or BRCA2 gene mutations, or other genetic conditions that increase breast cancer risk
  • A strong family history of breast cancer
  • Been diagnosed with cancer in one breast and are now considering removing the other
  • No current cancer detected

For these individuals, a preventative mastectomy could significantly reduce the risk of developing breast cancer during their lifetimes. If you fall into one of these categories, consulting with a plastic surgeon can help you determine the best course of action for preventative mastectomy and reconstruction options.

What Are My Options if I’m Considering a Preventative Mastectomy?

If you are someone who could benefit from a preventative mastectomy, you also have other options to consider. The most common options are monitoring or surgery, but some medications may also help prevent developing breast cancer and should be considered in consultation with your doctor.

  • Monitoring: If you choose this route, your healthcare team will set up routine check-ups, screening, and surveillance appointments to monitor any changes in your tissues and breast health.
  • Surgery: Preventative mastectomy surgery involves removing one or both breasts and can involve taking more or less tissue depending on your individual risk.

Both options have pros and cons that you should consider and discuss with your doctor. You are the only person who can decide if a preventative mastectomy is right for you. When a high-risk diagnosis is compounded by the emotional toil of deciding your next steps, it’s important to know who you can talk to.

Who Should I Talk To About Getting a Preventative Mastectomy?

You might think the only option for discussing surgical options like preventative mastectomy is with a breast surgeon but plastic surgeons are in a unique position to help you decide your reconstructive outcomes before your surgery ever happens. Consulting first with a plastic surgeon can reduce the stress surrounding your situation by providing you with:

  • Expertise and comprehensive information on mastectomy and reconstruction options.
  • A trusted and skilled breast surgeon for the mastectomy, so there’s no need for you to coordinate multiple doctors.
  • Financial guidance to coordinate with your insurance and reduce out-of-pocket costs.
  • Treatment continuity to provide you with seamless treatment and recovery from doctors and staff you recognize the whole time.

What Is a Preventative Mastectomy With Immediate Reconstruction?

One of the benefits of consulting with a plastic surgeon for preventative mastectomy is the variety of reconstruction options available to you. Because the surgery happens before cancer is detected, and depending on your personal risk level, there are options for removing more or less tissue during your preventative mastectomy and immediate reconstruction. Another benefit of immediate reconstruction is the ability to reduce your cancer risk while maintaining the visual appearance of your breasts.

Total (skin-sparing) mastectomy

Nipple-sparing mastectomy

  • Removal of breast tissue, nipple, and areola
  • Potential removal of surrounding lymph nodes
    • typically only in high-risk cases
  • Breast tissue is removed
  • Nipple and areola are spared
  • Common for those patients considering prophylactic surgery, such as those with BRCA-mutations

Your doctor can help you decide which surgical options are right for you and can also help you navigate the finer points of the process. One of the major considerations for those thinking about preventative mastectomies is how much of these procedures their insurance will cover.

Will My Insurance Cover Preventative Mastectomy and Reconstruction?

For many people who have a high risk of developing breast cancer, insurance will cover a preventative mastectomy and reconstruction. As mentioned above, “high-risk individuals” include those who:

  • Have a known genetic predisposition to breast cancer, such as  BRCA1/2 positivity
  • Have a family history of breast cancer
  • Have had a prior breast cancer (or other similar cancer) diagnosis

If you fall into one of these categories, you have an elevated risk of developing breast cancer and most insurance companies will deem preventative mastectomy and reconstruction as medically necessary and cover the procedures. In New York, if a process is considered medically necessary, there are state laws that require insurance to cover the preferred surgical path. This requirement is why many patients choose to work with a plastic surgeon from the start, so they can guide them through the process from beginning to end.

Are you considering a preventative mastectomy?

At Harris Plastic Surgery, every consultation includes a thorough evaluation of your Empire Plan coverage for breast reduction surgery. We take a concierge approach to treatment, which includes working to minimize your out-of-pocket costs. Contact Harris Plastic Surgery for help navigating the process.

Stephen U. Harris, MD FACS

Dr. Stephen U. Harris is a board-certified cosmetic surgeon and recognized expert in breast reduction and reconstruction surgeries, having performed thousands in his career. When it comes to patient care, his philosophy is that every surgery should improve his patient’s overall quality of life, not just their appearance. Dr. Harris stays up-to-date on all the latest advancements in breast augmentation, reconstruction, and reduction and is a recognized innovator in the field. In fact, he was the first surgeon at Good Samaritan Hospital to offer primary prepectoral implant breast reconstruction, as well as secondary prepectoral revision surgery.

Dr. Harris also serves as Chief of Plastic Surgery at Good Samaritan Hospital in West Islip, New York and is an active staff surgeon (and former Chief of Plastic Surgery) at South Shore University Hospital in Bay Shore, New York.

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