Prophylactic mastectomy – when does it make sense??
Breast cancer is the most common cancer in women. On average, one in eight women will develop breast cancer during their lifetime. Over 17 people die each year.800 women at it.800 women from it.
To prevent just that, many women opt for a prophylactic mastectomy – a breast removal procedure. But at what point is breast removal an option for a woman?. What exactly do you have to look for in this one?
Prophylactic mastectomy – What is it??
A mastectomy describes the
one-sided or removal on both sides the Mammary gland. This can be performed if breast cancer has already occurred or even beforehand preventive be performed. Because cancer does not come as a surprise and unexpectedly for all women. About five percent of all carcinomas of the breast are favored by a familial predisposition.
Basically, this means that certain gene mutations increase the risk of developing breast cancer. The exact causes of breast cancer are still largely unknown. Which, however, are already known Mutations at BRCA1– or BRCA2 gene. These cause a 50 to 80 percent increased risk of breast cancer. In a prophylactic mastectomy, the breast is removed before the tumor appears, thus prolonging survival.
At what point does a prophylactic mastectomy become necessary?
A prophylactic mastectomy is only considered for a woman if there is a very high risk of developing breast cancer.
Possible risk factors that may lead to a prophylactic mastectomy are:
BRCA1 or BRCA1 mutations: A test can find these gene mutations. According to the Cancer Information Service (KID) of the German Cancer Research Center (DKFZ), these mutations occur in about five to a maximum of ten out of every hundred patients.
Previous breast cancer: If one breast of a patient has already been affected by cancer, the other can be removed with a preventive mastectomy, reducing the risk of breast cancer
Dense breast tie: Some women have very dense breast tie, which can make diagnosis difficult. In combination with other risk factors, this can also be a reason for preventive treatment
radiotherapy: Radiation therapy that is administered before the age of 30. performed before the age of 18 can also increase the risk of developing breast cancer later in life Lobular carcinoma in situ (LCIS): In LCIS, abnormal cells spread in the lobules of the glands. Although these are not cancer cells, they are considered markers for an increased risk of breast cancer. Breast or ovarian cancer In the family: If two first-degree relatives have already developed breast cancer and at least one of them was diagnosed before the age of 50, there is an increased risk of breast cancer. If you are under the age of 50, there is also an increased risk of breast cancer.
In most cases, a gene mutation is the main reason for a prophylactic mastectomy. But even without a genetic mutation, a prophylactic mastectomy can be performed if the risk of developing breast cancer is too high.
How does a prophylactic breast removal proceed??
While in a woman who has already been affected by breast cancer, the aim of the operation is to preserve as much of the breast as possible, in a prophylactic mastectomy the opposite is the case: here the breasts are complete Removes.
A preventive breast removal is performed under general anesthesia. The operation is performed by a Gynecologist Or performed by a gynecologist. During surgery, the gynecologist removes the entire Glandular body of the mammary gland where a tumor could develop. The nipple and the skin covering the glandular body can either be removed or preserved. Whether it is necessary to Nipple and the Nipple areola removal is still under discussion. There is still no clear result to what extent the removal affects the risk of breast cancer. However, to keep the risk as low as possible, most doctors recommend that the skin flaps be prepared at least very thinly, since as much glandular tie as possible should be removed.
So that the emotional and physical stress In order to minimize the risk for the woman, the breast can be reconstructed aesthetically during the same operation Reconstructs are. However, this can also be done in a later operation. The patient and her gynecologist must decide which of the two options to take. The important thing here is that the reconstruction of the breast does not get in the way of the removal of the risky tie.
For the Breast reconstruction silicone implants or autologous tie can be used. A more appealing result can usually be achieved with the silicone cushion. The operation required for this is technically simpler. Here, the cushion can be inserted either in front of or behind the pectoral muscle. However, there is a risk that the body will reject the silicone implant, which can lead to pain and possibly another surgery.
Otherwise, the breast can be removed by flap transplants or flap plastic surgery can be reconstructed. Muscles are removed from other parts of the body, such as the back or abdomen and inserted into the breasts. However, this operation is very complex and demanding and should therefore only be performed by experienced surgeons.
Healing time and costs of prophylactic mastectomy
The Healing time a mastectomy can take very different forms. It will be much faster for young and fit women than for older women with possible pre-existing conditions. Most of the time, the patient can leave the hospital a few days leave again after the operation. However, it is important that an adequate pain therapy is carried out and that the wound continues to be observed.
Until the scar is completely healed, it can take several months pass by. Many women also ask themselves how long they will be on sick leave after a prophylactic mastectomy. As a rule, after a mastectomy, you are on sick leave for two weeks. However, this can vary individually depending on the patient. The development of wound healing varies. The cost of prophylactic mastectomy can amount to several thousand euros, depending on the complexity of the procedure. Since a prophylactic mastectomy is only performed if it is really medically necessary, the costs are covered by both the statutory and private health insurance companies.
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