BRCA1 Breast Reconstruction
BRCA1 is the name of a normal human gene that, when mutated in specific ways, will decrease the ability of cells to repair their DNA. The BRCA1 gene provides instructions for producing a specific protein that acts to suppress tumors. When these tumor-suppressor proteins are not allowed to prevent cells from growing and dividing in an uncontrolled fashion, health issues result. Researchers have discovered more than 1,800 mutations in the BRCA1 gene, and these mutations, unfortunately, lead to a highly increased risk for the development of breast and ovarian cancers. Generally speaking, the lifetime risk of developing breast cancer in an American woman is 12%. That figure dramatically increases to 80% if a woman possesses an active BRCA1 mutation. With that being said, not everyone who inherits a mutation in the BRCA1 gene will develop cancer.
Interestingly, everyone has BRCA1 (Breast Cancer 1), as well as BRCA2 (Breast Cancer 2) genes. However, if a woman inherits, or develops, an active BRCA1 mutation, they are treated with close monitoring or with proactive preventive removal of both breasts, so-called, bilateral prophylactic mastectomies. Also, the preventive removal of a woman’s ovaries is an option that decreases the risk of future breast and ovarian cancers. The percentage of breast cancers associated with hereditary genetic predispositions (abnormal genes passed from parent to child) is quite low – anywhere from 5% – 10%. However, most of those inherited cases of breast cancer are associated with an abnormal BRCA1 or BRCA2 gene. How breast cancer may develop directly due to environmental factors is not entirely known. The bottom line remains: most women who develop breast cancer do not inherit an abnormal breast-cancer gene, nor do they have any known family history of the disease.
"Dr Chevray did an amazing job on my abdominoplasty. I could not believe the difference it made, as I have been carrying around ‘extra’ tummy weight for years. Dr Chevray was a blessing to me. Also he has the best team with Patrick and Carol. They all treated me as if I was there one and only patient. It made me feel very special. Highly recommend Dr Chevray!"- M. / RealSelf / Mar 24, 2020
"I saw Dr Chevray for breast reconstruction. I highly recommend him. Patrick and Carol are awesome. It was a very scary time for me and they made me feel special. I had a few bumps during recovery but he and his staff were always available to me. I can not express how thankful I am for this wonderful team."- W.B. / Facebook / Jan 31, 2020
"Dr Chevray did an amazing job on my abdominoplasty. I could not believe the difference it made, as I have been carrying around ‘extra’ tummy weight for years. Dr Chevray was a blessing to me. Also he has the best team with Patrick and Carol. They all treated me as if I was there one and only patient. It made me feel very special. Highly recommend Dr Chevray!"- Anonymous / RateMDs / Mar 23, 2020
"I saw Dr Chevray for breast reconstruction after mastectomy. He is kind, compassionate and very caring. His PA Patrick and nurse Carol are fantastic. They were always available for me at any time during my recovery. Words can not express how thankful I am for this team. I would highly recommend him if you ever need top notch care for reconstructive surgery."- W.B. / Healthgrades / Feb 01, 2020
"Wonderful Caring Team - Dr Chevray, Patrick and Carol were all wonderful, sympathetic and caring. All my questions were answered, they gave me plenty of time and I am very pleased with my results. After my cancer they were very quick to respond and made sure I understood everything that was happening."- J. / RealSelf / Jan 31, 2020
IF YOU TEST POSITIVE FOR AN ABNORMAL BRCA1 GENE
If you have tested positive for the BRCA1 mutation, you are at a much higher risk of developing breast and/or ovarian cancers. Lowering any daunting risks includes the following:
Preventive or Prophylactic Mastectomy
Preventive or prophylactic mastectomy refers to the removal of both breasts, and this option offers encouragement since this procedure has been found to reduce the risk of breast cancer – even in high-risk women – by a whopping 90%! Women receiving a preventive mastectomy will undergo one of two procedures:
With a skin-sparing mastectomy (also known as a simple mastectomy, or total mastectomy), the nipple, the areola, and all of the breast tissue are removed. The breast skin envelope is spared and remains. The extraction of the axillary (underarm) lymph nodes does not take place, and muscles remain intact.
With a nipple-sparing mastectomy (also known as a subcutaneous mastectomy), the breast tissue is removed, but the nipple, areola, and all of the breast skin remain. This procedure is performed less frequently than the skin-sparing mastectomy because is it technically more difficult to perform well, and there is a risk that the nipple and areola may not survive the mastectomy procedure. However, if the nipple-sparing mastectomy is done well, then Dr. Chevray can reconstruct the breasts so that they appear to have had a cosmetic augmentation or breast lift and not a mastectomy. Dr. Chevray works with experienced and technically skilled breast surgeons who are capable of performing nipple-sparing mastectomies, even in patients who have had previous breast surgery or previous breast radiation.
Preventive or Prophylactic Oophorectomy
Preventive or prophylactic oophorectomy involves the removal of both ovaries, and when performed prior to the onset of menopause, the likelihood of developing breast cancer, as well as ovarian cancer, can be minimized. The reason lies with the fact that the removal of ovaries before menopause negates the body’s primary source of estrogen.
Expected Side Effects of Prophylactic Mastectomy
As with any surgery, there can be side effects, and Dr. Chevray will cover this topic with you. Some risks or considerations include:
- Loss of sensation in the breast
- Inability to breastfeed
- Infection or bleeding
- Collection of body fluid at the surgical site
- Delayed healing of the wound
- Formation of thick scar tissue
- Possible anxiety about body image
Contact Us Today
During a one-on-one consultation with Dr. Chevray, you will receive the insight you desire to make a comfortable, fully informed decision. Dr. Chevray is an expert in the field of breast reconstruction, and his experience, skill, and bedside manner are unsurpassed. He will address any questions or concerns in a transparent and easy-to-understand manner, and replace apprehension with confidence and encouragement.