The recent disclosure by actress Angeline Jolie of a preventative mastectomy and breast reconstruction is of great interest to women who seem to be predisposed to breast cancer by family history or through genetic factors. Preventative mastectomies and immediate reconstruction, according to Dr. Mark Jewell, a board-certified plastic surgeon, practicing in Eugene, Oregon represent an option that should be considered. According to Dr. Jewell, this is a procedure that is individualized for each patient, based on her breast health history, family history, and genetic testing.
Preventative mastectomies have been performed for many years, but recent advances in the way that the mastectomy and reconstruction is performed offer options such as nipple-sparing procedures and the use of anatomically-shaped highly cohesive gel breast implants along with materials used to reinforce the lower breast region following the mastectomy. Dr. Jewell has over 12 years of experience with the recently approved Allergan Natrelle 410 implant in breast reconstruction. He has over 2 years’ experience with research on newer biomaterials used for lower breast reinforcement during reconstruction. Some women can be reconstructed in a single procedure, known as “direct to implant reconstruction”. Others generally require a two-stage procedure where a tissue expander is placed at the time of the mastectomy and a second procedure is needed to place the permanent implant.
Patient contemplating preventative mastectomies must understand that this is a complex surgical procedure with the possibility of complications. It is not a cosmetic procedure, like the augmentation mammaplasty, but a specialized form of breast reconstruction. It is thought that this operation will reduce, but cannot eliminate the risk of breast cancer in a patient who may be pre-disposed because of family history or genetic factors.
The other good news for women with regards to preventative mastectomies is that this is a procedure that is covered by health insurance. Breast reconstruction procedures have been covered according to the Woman’s Health and Breast Cancer Act of 1998 law.