Prophylactic mastectomy for precancerous and high-risk lesions of the breast.

The candidates for prophylactic mastectomy are those who have a family history of breast cancer, multiple fibrocystic masses that have been biopsied or are too numerous to biopsy appropriately, or patients who previously have had cancer in one breast. The decision to perform the subcutaneous mastectomy is one that must be made by the surgeons involved, in consultation with the patient and her husband. The data from subcutaneous mastectomies appear promising and the technical results have improved as experience has been gained. However, 5 to 10 more years are necessary to determine whether this procedure decreases the incidence of breast cancer in these high-risk patients.