RISK REDUCTION MASTECTOMY A NEW STRATEGY FOR PRIMARY AND SECONDARY PREVENTION OF BREAST CANCER– A LITERATURE REVIEW.

Background: In the last decade there has been a marked increase in the number of women requiring risk reduction mastectomy either before the development of breast cancer in high risk population or following the diagnosis of unilateral breast cancer. The breast surgeon and the oncologist are usually faced with difficult questions regarding the impact and the outcome of the various strategies that are used for risk reduction. This includes prophylactic mastectomy, close surveillance programs or chemoprevention. The outcome of these strategies and their effects on disease relapse and survival particularly prophylactic mastectomy either bilateral risk reduction mastectomy (brrm) for primary prevention or contralateral risk reduction mastectomy (crrm) for secondary prevention remains challenging and an area of great interest. Methods and data sources: a narrative literature review was performed using the available electronic database. This was intended to assess the available tools for risk assessment in addition to the impact of prophylactic mastectomy (bilateral in high risk individuals or contra-lateral in unilateral breast cancer patients) on the following: 1. Breast cancer risk reduction & outcome. 2. Decision making process in women at a high risk for bilateral or contralateral breast cancer. 3. Patients satisfaction and psychological status after surgery. Conclusion: Risk reduction prophylactic mastectomy in the form of bilateral or contralateral mastectomy is considered one useful strategy in patients at a high risk of breast cancer or with patients with unilateral breast cancer respectively. This strategy is recommended in some national and international guidelines.