ABSTRACT
This chapter focuses on evidence behind this procedure in attempts to understand its role for clinicians. Prophylactic or ‘risk-reducing' mastectomy refers to the procedure of completely removing a healthy breast in order to reduce the risk of developing breast cancer. Removal of a healthy breast may be offered to reduce the risk of cancer in that breast or, much less frequently, for symmetrisation, as an alternative or indeed an adjunct to breast reconstruction. The ‘Jolie effect' is a recognised driving force behind awareness of BRCA status in patients, and thus subsequent presentation and desire for risk-reducing procedures. In the absence of a proven survival benefit, the rationale for CPM may be to reduce anxiety and for an improvement in quality of life. The ‘extended findings', even if proven to be benign, may result in an increased level of anxiety regarding future cancer development, which may influence the decision to undergo contralateral mastectomy.
