What should you know about risk reducing mastectomy and reconstruction?

Risk-reducing mastectomy removes breast tissue to lower future breast cancer risk, while reconstruction reshapes the breast area during or after surgery. The decision is personal and should follow a careful discussion of inherited risk, screening, body image, surgical choices, and recovery.

Risk assessment may include family history, genetic counselling, and BRCA genetic testing when appropriate. Breast MRI or other surveillance can be discussed as an alternative or addition, depending on your risk and preferences. A risk-reducing operation lowers risk but does not remove every breast or cancer risk.

Reconstruction may use an implant, tissue from another area of the body, or a staged approach. Some people choose no reconstruction. Nipple- or skin-preserving options may be possible for selected patients, but anatomy, safety, previous operations, and surgeon assessment determine eligibility.

Meet the breast surgeon and reconstructive surgeon before deciding. Ask how much tissue will be removed, whether one or both breasts are involved, where scars may sit, and whether reconstruction is immediate or delayed. Review smoking, medicines, healing conditions, and plans for future screening.

Arrange help with meals, children, transport, and arm movements during early recovery. Follow wound and drain instructions, attend review visits, and allow time for the breast shape and sensation to change as healing progresses. Emotional support can be as relevant as surgical planning.

Contact the surgical team promptly for increasing redness, swelling, warmth, wound opening, drainage changes, fever, worsening pain, or a sudden change in the reconstructed breast. Seek urgent help for chest pain, severe breathlessness, fainting, or sudden swelling and pain in an arm or leg.

What is my estimated inherited and personal risk? Should I have genetic counselling or BRCA testing? What screening plan applies if I do not have surgery? Which reconstruction methods suit my body and health? What sensation, scars, revisions, and recovery should I expect?