Subcutanteous mastectomy for treatment of breast cancer

[BBTyler]

I am 41 years old and have recently been diagnosed with breast cancer.  Mammogram picked up a very small area of microcalcifications.  This area is no where near the nipple. It's mid lower.  I underwent a steritactically guided biopsy with pathology report showing a very small area of intraductal carcinoma and even smaller area of invasive carcinoma.  



I have a very strong family history of breast cancer...2 paternal aunts died (one at 35, the other in her 50's), another in her 60's is in remission, and my maternal grandmother died at 51, as well as her sister.  



I would like to undergo bilateral sucutaneous mastectomies with implants for treatment for the existing cancer, as well as a prophylactic reasons on the other breast.  



My question is, will this eliminate radiation on the breast with cancer? What are my chances of developing breast cancer in that breast again after subcutanoues mastectomy if the nipples were spared? How often is subcutanous mastectomy performed and successful for the treatment of cancer?    



I have an appointment with a plastic surgeon who also works with a general surgeon to talk this over but am being pressured to just undergo the lumpectomy with radiation now and then have reconstruction surgey later.  What is your advice?   Thanks!!

[CCF-RN,MSN-JS]

Dear BBTyler,  Subcutaneous mastectomy refers to a procedure where the surgeon removes all of the breast tissue except the nipple and areola.  This procedure might be used when a woman desires a prophylactic (preventive) mastectomy. Subcutaneous mastectomy is not usually recommended for women who are known to have breast cancer already.   There are some surgeons who will do a "nipple-sparing" surgery, assuming the cancer is a location where sparing the nipple represents little to no risk.  The nature of the procedure in any specific case would need to be determined by the surgeon.  Another option for you is to seek a second opinion both from the point of view of the breast cancer surgery, as well as the plastic surgeon. The decision about prophylactic surgery is a personal one. Bilateral mastectomy significantly reduces but does not eliminate the risk of developing another cancer in the breast. If the cancer is small, margins are clear and there is not extensive lymph node involvement, radiation may not be required following mastectomy.