Breast Reduction Surgery and Cancer Risk

Does Breast Reduction Reduce Cancer Risk?

Studies have shown that breast reduction surgeries can significantly reduce an individual’s risk of developing breast cancer. According to research by the National Cancer Institute, breast reduction surgery can reduce cancer risk by up to 95% for women with a harmful mutation in the BRCA1 or BRCA1 gene. It can reduce risk by up to 90% for women who do not have a gene mutation but do have a strong family history of breast cancer.

How Does Breast Reduction Surgery Reduce Cancer Risk?

Breast reduction surgery reduces cancer risk primarily by reducing the amount of tissue that can become cancerous. For this reason, the exact degree of risk reduction depends on the specific procedure. The more breast tissue that is removed, the more a person’s cancer risk will be reduced:

• Total mastectomy: This procedure removes all the breast tissue, nipple, and areola. It removes the most tissue, thus providing the best benefits for cancer risk reduction.
• Nipple-sparing mastectomy: This procedure preserves the nipple and areola for more natural-looking breasts after reconstruction. It is slightly less effective at reducing cancer risk.
• Breast reduction: This procedure preserves a variable amount of breast tissue depending on the intended result. It reduces cancer risk, though not as much as mastectomy.

People should keep in mind that no procedure is 100% effective at preventing cancer. It is impossible for surgeons to remove all tissue that may become cancerous, meaning there is always a chance of developing cancer even after receiving surgery.

What Is Prophylactic Surgery?

A prophylactic procedure is one performed to prevent future illness. Because breast reduction surgery can reduce cancer risk, physicians often recommend it for preventative reasons. In this case, bilateral prophylactic mastectomy is a breast reduction or removal that is performed specifically to reduce the  risk of developing cancer. It is an elective procedure, meaning it is not required for the person’s health. It is often strongly recommended, however, especially for people at higher-than-average risk of developing breast cancer.

When to Consider Getting Preventative Surgery

Not every woman needs to consider getting preventative surgery. These procedures are invasive, physically taxing, and result in an altered appearance. Though they do reduce cancer risk, the benefits may not be worth it for individuals at low-to-average risk of cancer. Instead, prophylactic or preventative procedures are most often recommended for at-risk individuals. These are the most important risk factors for consideration when deciding whether to pursue surgery:

Post-Menopause

Breast cancer is most common in older women, especially those who have finished menopause. In these women, breast cancer risk increases in relation to breast size and weight gain. This means a breast reduction will be more effective in reducing cancer risk.

Gene Mutations

Preventative breast reduction surgery is most effective for women with certain hereditary gene mutations. The BRCA1, BRCA2, and several other genes are responsible for repairing damaged DNA. Mutations in these genes may cause them to repair DNA improperly, resulting in changes that turn cells cancerous. Individuals with these mutations are at a much higher risk of developing cancer.

Family History

Evidence has shown that some cancer risk factors are hereditary. Even if a woman is not aware of a gene mutation, a strong family history of breast cancer may indicate that she is also at risk. This is especially true if family members developed the disease early in life.

Previous Breast Cancer Diagnoses

Medical advances have greatly increased the effectiveness of breast cancer treatment. Even after a successful treatment, however, there is a chance that the cancer may come back. Patients who have already been diagnosed with breast cancer and undergone treatment may consider preventative surgery. This step may prevent cancer remission and help the patient avoid a second round of treatment.

Does Health Insurance Cover Preventative Surgery?

Surgery, especially major surgeries like breast reduction and removal, is expensive. While it may reduce a person’s likelihood of life-threatening disease, not everybody can justify the expense. Health insurance exists to help people pay for necessary medical procedures. It can be difficult, however, to predict which procedures insurance will cover.

Many health insurance companies will only cover medically necessary surgeries. Whether or not a risk-reducing surgery is considered medically necessary often depends on the insurance provider and the specifics of their policy. Some companies require a second opinion or a letter from the healthcare provider to confirm the medical necessity. Anybody considering risk-reducing breast reduction surgery should discuss potential coverage issues with their physician before proceeding.

How Else Can People Reduce Breast Cancer Risk?

Though breast reduction surgery can reduce cancer risk, there are many reasons not to pursue it. Some individuals may not be at great enough risk to consider it necessary. Others may face financial obstructions, or they may simply wish to avoid the stress and physical changes associated with surgery. Fortunately, there are other steps a person can take to reduce their cancer risk. These include:

Maintaining a Healthy Weight

Weight gain and larger breasts are associated with a higher risk of breast cancer, especially after menopause. Therefore, women can reduce their risk by maintaining a healthy weight. They should also avoid rapid and significant weight gain, even if they lose weight afterward.

Exercising Regularly

Vigorous physical activity helps to prevent weight gain and can reduce cancer risk in other ways. Physicians suggest a minimum of 150 to 300 minutes of moderate-intensity exercise each week, 75 to 150 minutes of vigorous or high-intensity exercise, or a combination of both.

Screening Frequently

Most guidelines recommend that women start breast cancer screenings after age 45. Women at an increased risk of cancer, however, may wish to start earlier or schedule mammograms more frequently. This increases the likelihood of detecting cancer early, allowing for more effective treatments.

Taking Risk-Reducing Medication

The U.S. Food and Drug Administration (FDA) has approved a few medications to reduce the risk for women with a strong family history of breast cancer. Women should speak with their physician about whether risk-reducing medication, also called chemoprevention, is right for them.

Learn More About Surgery and Breast Cancer Risk

Anybody can be affected by breast cancer, which is why it is important to understand the risks. Regional Cancer Care Associates educates patients to help them avoid life-threatening cancer. RCCA specialists provide care to more than 30,000 new patients and 265,000 established patients each year. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers close to home.