Until recently few patients at The University of Texas M. D. Anderson Cancer Center (MDACC) underwent “prophylactic mastectomy”—elective removal of what was thought to be a normal breast. The small group who did undergo this procedure included patients with a strong family history of breast cancer and thus a markedly increased risk of developing the disease and the occasional patient electing a contralateral mastectomy at the time of treatment of an index breast cancer. The typical patient in the latter group was an older woman with extremely large and pendulous breasts who wished to avoid the anticipated asymmetry. Overall, only two or three patients per year underwent removal of a normal breast even though many patients were at high risk because of a strong family history or a previous breast biopsy that revealed atypia or lobular carcinoma in situ.
Unable to display preview. Download preview PDF.