Prophylactic Surgery

Prophylactic breast surgery, also known as bilateral prophylactic mastectomy, involves removing both breasts to significantly reduce the risk of developing breast cancer.
This procedure is particularly indicated for women who carry genetic mutations such as BRCA1, BRCA2 or PALB2, which are associated with a high likelihood of developing breast or ovarian cancer.

By removing tissue that could potentially become cancerous, this preventive surgery allows patients to act before the disease appears. In most cases, immediate breast reconstruction can also be planned.

Prophylactic mastectomy is considered in several situations:

• Family history: A strong familial background of breast or ovarian cancer may indicate increased genetic risk.
• BRCA1, BRCA2 or PALB2 mutation: These mutations significantly raise the risk of developing breast cancer.
• Personal history of breast cancer: When cancer has affected one breast, preventive surgery may be considered for the other.
• Other genetic syndromes: Such as Li-Fraumeni or Cowden syndrome.

This decision is made after comprehensive evaluation by a multidisciplinary team of oncologists, surgeons, and genetic counselors.

Several surgical techniques can be considered for prophylactic mastectomy. The choice depends on the patient’s body type, desire for reconstruction, and the technologies available at the surgical center.

Robotic Surgery

Robot-assisted breast surgery is a major advancement in modern medicine. Using state-of-the-art technology, it enables highly precise procedures, minimizing scars and optimizing aesthetic outcomes.
It is used in breast reconstruction, lumpectomy, and prophylactic surgery in high-risk patients.
The surgeon operates remotely via a console, benefiting from 3D high-definition vision, which improves oncologic accuracy, reduces complications, and accelerates recovery.

Endoscopic Surgery

Endoscopic breast surgery is a minimally invasive alternative to traditional techniques. It is used for various procedures, including augmentation, post-cancer reconstruction, and some prophylactic mastectomies.
A camera inserted through a small incision provides a clear view of internal tissues, allowing for precise dissection and preservation of surrounding structures.

This technique reduces visible scarring, post-operative pain, and shortens recovery time.
In mastectomy, it enables precise removal of breast tissue and facilitates immediate reconstruction with implants or autologous tissue.

Pre-Pectoral breast reconstruction

After mastectomy, breast reconstruction may be performed immediately or later. The pre-pectoral technique involves placing the implant above the pectoral muscle, rather than underneath.

This avoids muscle dissection, reduces pain, and achieves a more natural appearance. With the use of biological matrices, this technique offers better tolerance and enhanced aesthetic results.

When possible, this method can be combined with nipple-sparing mastectomy, further improving the final cosmetic outcome.

Recovery depends on the surgical method used.
Generally, patients can return home within 24 to 48 hours after the procedure. Post-operative pain is moderate and well managed with standard analgesics.

A close follow-up is implemented to monitor healing and prevent complications such as infection, hematoma, or delayed wound healing.
Daily activities may be resumed within a few weeks, while sports activities are usually advised after 6 to 8 weeks.

Patients who undergo prophylactic breast surgery typically experience a drastic reduction in breast cancer risk, often exceeding 90%.

From an aesthetic perspective, modern reconstruction techniques allow for natural and harmonious results.
However, this is a major decision that must be carefully considered with the support of an experienced medical team.

Psychological support also plays a key role in helping patients process the journey and adjust to their new body image.