Dear MAYO Clinic: I have tested positive for the breast cancer “gene” (BRCA1), and I have a family history of breast cancer. I don’t feel comfortable with the idea of prophylactic mastectomy at this time. (I’m 31.) Are there other things I can do to prevent cancer without surgery?
Answer: For women who have a mutation in the BRCA1 or BRCA2 gene – genes linked to breast and ovarian cancer – surgical removal of the breasts can significantly reduce your cancer risk. There’s no clear right or wrong answer about if or when that should be done, however. It is an individual choice for you to make after learning as much as you can about your own situation and carefully considering what you prefer.
Women who have harmful changes, or mutations, in either the BRCA1 or BRCA2 genes have a much higher risk of developing breast or ovarian cancer than other people. Having one of these gene mutations does not mean you’ll definitely get cancer, though.
Surgical removal of healthy breast tissue is one way to reduce your risk and help prevent cancer.
But surgery is not the only alternative. Many people who’ve tested positive for the BRCA1 or BRCA2 mutation choose to be part of a high-risk surveillance program. These programs offer close monitoring, such as having clinical breast exams every six months and mammograms and magnetic resonance imaging (MRI) exams every year. These tests may help detect cancer early.
Dr. Judy C. Boughey is a surgeon at the Mayo Clinic.