Prophylactic Surgery to Reduce the Risk of Developing Breast Cancer: Issues and Clinical Implications

Women with BRCA1 or BRCA2 mutations are at increased risk of developing breast and ovarian cancer. Options to manage this risk are regular surveillance, chemoprevention, and risk reduction surgery which includes, risk reduction mastectomy (bilateral or contralateral) and risk reduction salpingo-oophorectomy. Risk-reduction surgery (RRS) has been proven to be efficacy in the reduction of breast and ovarian cancer up to 90% but are irreversible procedure and psychological and physical implication could be challenging for women. Authors provide an overview of the current literature regarding efficacy of RRS, acceptability and psychological implication. Decisions about RRS are complex owing to the multiple associated risks and benefits. Specific and multidisciplinary approach is needed. Many factors, mostly psychological, influenced the decision. Research on psychological impact of these procedure are controversial. The majority of these studies reported that women who choose surgery have diminished anxiety about cancer risk, and experience few psychological difficulties, but physical complication and change in body image, sexual life are often reported. In conclusion, women need to be counselled about the decision to undergo RRS Potential negative effects of should be discussed thoroughly with each woman considering this procedure. Careful psychological follow up after the surgery should be scheduled.