A side by side diagram comparison of two breast conserving surgeries: a lumpectomy and a partial mastectomy.

Options for women with BRCA gene mutations who are considering breast reconstruction surgery

  • A side by side diagram comparison of two breast conserving surgeries: a lumpectomy and a partial mastectomy.

    With the recent news regarding Angelina Jolie’s courageous story, questions about breast cancer treatment, as well as breast reconstruction, have become common topics for discussion.

    Women who learned they have a mutation in the BRCA1 or BRCA2 genes have an approximately 5-fold increased risk of developing breast cancer. Another way to describe this would be to say that approximately 80-90 percent of patients with these genes will eventually develop breast cancer. In addition, 50-60 percent of patients may also develop ovarian cancer.

    Treatment for patients who have been found to have the BRCA1 or BRCA2 genes are generally performed to prevent the development of cancer in the future.  For these patients, mastectomies to remove the breasts are usually recommended, just like Angelina Jolie.  The breasts may be removed while saving all the skin and potentially even the nipples.

    These patients may then undergo reconstruction of the breasts. Certainly breast reconstruction should be offered to all patients undergoing mastectomies. There are several options for reconstruction including the placement of implants, which is the type of reconstruction performed for Angelina Jolie.

    Another option for reconstruction would be to use the patient’s own fat and skin to reconstruct the breasts. The first option is much simpler with a shorter recovery period, while the second option takes more time.

    For patients who are very thin, as in Angelina Jolie’s case, surgery using implants would be the primary option because there is not enough fat and skin to reconstruct both breasts. But for those patients who do have some extra fat around the stomach area, using the skin and fat (called flap procedures) may be a better option especially in those patients who are younger. Because the recommended warranty on implants is only 10 years, patients who are younger may require additional surgeries in the future to replace the implants.

    For instance, since Angelina Jolie is only 37 years old, she may need another operation when she is 50 years old to replace her current implants. Clearly, if a patient chooses to use her own skin and fat to reconstruct her breasts, she does not have to worry about these additional surgeries in the future to exchange the breast implants. Regardless of the type of reconstruction that one chooses, several steps are usually required to complete the final reconstruction which can take up to one year.

    However, both options for reconstruction can give beautiful results and are commonly performed at Fox Chase Cancer Center by a team of surgeons who specialize in breast cancer surgery and reconstruction. Visit Fox Chase for more information to to schedule an appointment.