What to expect from risk-reducing mastectomy for a BRCA gene mutation

A BRCA1 or BRCA2 mutation can increase the chance of breast cancer. Risk-reducing mastectomy removes breast tissue before cancer develops; it cannot remove every breast cell, so ongoing clinical attention remains relevant. The surgeon will discuss whether the skin, nipple or both can be preserved safely for your situation.

Some people choose reconstruction during the same operation, while others delay it or use an external breast form. Reconstruction may use an implant or tissue from another body area. Numbness, altered sensation, scars, swelling and changes in body image are possible. Your breast and reconstructive surgeons should explain the expected stages.

Meet the breast surgeon, reconstruction team and genetics professionals as needed. Review family plans, other cancer risks, medicines, smoking, and the timing of any planned ovarian-risk surgery. Before the operation, arrange help at home, comfortable clothing and a plan for wound and drain care. Recovery activities are increased gradually according to your surgical instructions.

More detail is available in [Risk-Reducing Mastectomy](/treatments/risk-reduction-and-prevention/risk-reducing-mastectomy/).

Call your surgical team for increasing redness, warmth, drainage, wound opening, fever, or swelling that is worsening rather than settling. Seek urgent help for sudden breathlessness, chest pain, fainting, or a rapidly expanding swelling. Follow the discharge instructions even when a symptom seems minor.

Which mastectomy technique is suitable for me? When would reconstruction happen? What sensation and movement changes should I expect? How will you manage drains and pain? What follow-up is needed after surgery?