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About Chest Surgery
Based on the information you gave us, you’ve had a risk-reducing mastectomy. This means you’ve had surgery to lower your chances of getting chest cancer. This might have been because of things like your genetic test results, family history of cancer, or past cancer. Your risk is now much lower than before surgery—but it’s not zero. It’s still important to understand your body and what follow-up care may be needed.
It’s important to remember we are not including your risk of other chest cancers, like lung cancer, in this guidance.
- Cancer risk-reducing mastectomy: Main goal is reducing chest cancer risk as much as possible
- A surgery for people at high risk for chest cancer based on their family history of cancer or genetic risk.
- This surgery might also be done after someone has cancer to prevent the cancer from coming back.
- Often includes removing the nipples.
- Top surgery: Main goal is gender care, not cancer prevention
- Removes much, but typically not all, of the tissue that can get chest cancer.
- Some tissue is left behind to build a masculine chest shape.
- For some people, the nipple is kept on the chest. Some people get nipple grafts.
What is a risk-reducing mastectomy?
A risk-reducing mastectomy is a surgery designed to remove as much breast tissue as possible to prevent cancer. This is sometimes called a prophylactic mastectomy. It’s sometimes recommended for people who:
- Have a genetic risk for cancer (like BRCA1, BRCA2, or other high-risk genetic variants).
- Have a family history of breast, ovarian, pancreatic, prostate, or related cancers.
- Have had cancer in one breast and are trying to reduce risk in the other.
Unlike top surgery, where some tissue is intentionally left behind to shape the chest, a risk-reducing mastectomy:
- Removes nearly all the breast tissue, including tissue under the nipple to lower chest cancer risk.
- Often includes nipple removal, although some people keep their nipples when medically appropriate.
What does this mean for my cancer risk?
After a risk-reducing mastectomy:
- Your risk of chest cancer is dramatically lower.
- There is still a very small risk for cancer, since it’s impossible to remove all tissue that could become cancerous.
- If you kept your nipples, a tiny amount of breast tissue might remain in the nipple area. This means there’s a very low chance cancer could develop there.
What should I do next?
You likely do not need routine chest cancer screening, but this depends on:
- The type of surgery you had
- Whether you kept your nipples
- Whether you’ve had cancer
- The reason you had surgery
If you have a genetic risk, consider ongoing care with:
- A genetic counselor
- A high-risk cancer clinic
- A provider who understands gender-affirming and cancer care
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