Challenge in Breast Cancer Treatment: Is Prophylactic Mastectomy Indicated?

Significant controversy has arisen regarding the fate of the contralateral breast patient diagnosed with breast cancer. Women with lobular carcinoma, strong family history of breast cancer, inherited breast cancer gene, and childhood irradiation frequently choose surgery over surveillance. The decision becomes difficult when the patient has in situ cancer, fibrocystic disease, and no family history but requests bilateral mastectomy. Currently, there are no set guidelines for prophylactic mastectomy. During the last 5 years, we have done 52 bilateral breast reconstructions. We retrospectively studied the records of all patients who had prophylactic mastectomy. Our results of indications and a review of reported series will be given.