A guide to establishing the risk for breast cancer in the plastic surgery patient.

Plastic surgeons with a practice that includes breast augmentation, breast reduction, and breast reconstruction should have a working knowledge of both genetic and environmental breast cancer risk factors and of risk stratification of these patients. Specific tests to determine genetic susceptibility to certain cancers have become increasingly prevalent during recent years. Such testing is carried out by multidisciplinary teams, which may include plastic surgeons. Patients with a very strong family history of positive genetic testing for BRCA1 or BRCA2 may be offered prophylactic mastectomies. The authors present an overview of risk factors so that surgeons can stratify women appropriately with respect to their breast cancer risk. In addition to a brief literature review, the authors present 2 patients who represent the type of personal and family history of breast and/or ovarian cancer, and environmental risk factors that one would typically encounter in a plastic surgery patient population.