Dr. Wasif explains if a woman is still at risk for breast cancer after a nipple-sparing mastectomy and recalls why a family history increases the risk for this condition.
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Breast Cancer Risk after a Nipple Sparing Mastectomy That’s a good question. You know, theoretically the answer would be potentially yes, but there’s a reason why we started doing this and the reason is that over the years we found that when you do happen to have a breast recurrence of cancer it’s almost never at the nipple, and so far in the women we’ve done this over the last five to ten years we have found that there’s a pretty low level of recurrence of cancer behind the nipple. So we think that long-term it should be relatively safe to do, but we are still going to wait for the data to prove that but yet we still do this because we think it’s going to be okay. It’s a good question and, you know, there’s no simple answer to that. The important thing to remember is that breast cancer is very common. About one in eight women will get breast cancer over the course of their lifetime. So if you have eight relatives who are female, one of them is going to get breast cancer. Now, does that necessarily translate to an increased risk for you? No, that’s to be expected. However, about 10 to 15% of breast cancer does run in families and we have certain genetic genes that we have identified that cause that kind of a breast cancer. So if you have say more than two female relatives who have had breast cancer you might want to discuss that with your physician because there are tests that we can do for these genes, and if you have that gene then that can alter your therapy. We would in most cases recommend that you have a double mastectomy to minimize your risk of getting breast cancer in the future. We recommend that you start by talking to a genetic counselor because this has implications not only for you, but if you have children, especially female children, it has implications for them, and at the Mayo Clinic in Arizona that’s part of our multidisciplinary team. When we see patients in which we suspect that they have a genetic component to their breast cancer or, like you, they test positive for the BRCA-1 or the BRCA-2 gene we always recommend that they undergo some counseling and sit down with our genetic counselor. The important thing is with either BRCA-1 or BRCA-2 that even though you may not have breast cancer at this time, we think that over the course of your life you will have an upwards of 60 to 80% chance of developing breast cancer, and when we present those odds to most women, most of them will choose to undergo what we call a prophylactic bilateral mastectomy whereas even though you don’t have breast cancer, you choose to go ahead and have the breast removed to minimize your chances of ever getting breast cancer.