Saturday, February 23, 2008

Prophylactic Mastectomy: What You Should Know Before You Do It

More and more women who are at high risk of getting breast cancer are choosing to have prophylactic mastectomies -- surgical removal of both breasts -- to reduce their risk. It is a viable option and one that is certainly worth considering. But I've learned that many women in this situation often fail to consider all that's at stake. Let me clue you in so that you are empowered with the right information should you ever have to make this decision.

Every woman considering prophylactic mastectomy should have a mammogram at least 3 months before the surgery date. It's important to have this diagnostic evaluation to ensure that, to the best of anyone's knowledge, you are having "prophylactic surgery." You don't want to find out later that you, in fact, have cancer that could have been detected with a mammogram.
In general, it isn't necessary to remove lymph nodes in your axillae (under the arms) when you are having this type of surgery.

Sentinel node biopsies and axillary node dissections are for women who have breast cancer, not for those taking preventive measures to avoid getting the disease. Yet for some reason some doctors are still removing nodes in this situation, unnecessarily placing their patients at increased risk of lymphedema, a painful complication of lymph node removal.

Ask the surgeon what steps are taken in the pathology lab to thoroughly check the breast tissue that was removed in surgery for hidden cancer that may need to be properly staged and treated. This is important.

If your breasts are dense and difficult to image, request that a breast MRI be taken before your preventive surgery. Be sure that what you are having removed is healthy tissue and not breast tissue that already has cancer in it.

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