Prophylactic Choice

Breast cancer is a disease no woman wants to experience, let alone more than once. That's why some women at higher risk of a recurrence are choosing a controversial procedure - a prophylactic mastectomy - the removal of both breasts.

"I was kind of like what you would call the model of health. I mean, somebody who exercises everyday, somebody who eats low fat, doesn't eat a lot of meat, runs everyday and drinks green tea! So, it was, it was quite a shock."

Hilda Scharen found a little lump. It was smaller than the size of a pea. The scare sent her straight to her gynecologist for a baseline mammogram.

"As it turned out, they found inductal carcinoma insitu in two areas which were not related to that little lump. I was angry, that was my first reaction. I was taking all of the preventive measures."

Hilda was only 39. She thought of conserving her breast with a lumpectomy.

"I consulted with at least three doctors. The concern was that if it happened to be in another area in the breast then what do you do?"

In Hilda's case, the high risk candidate made what some would see as a drastic decision - to remove the diseased breast as well as the healthy one.

"Although it sounds terrible, the data for prophylactic mastectomies is that its preventability is about 95%. So, if you're a woman who's at high risk for getting breast cancer because of your family history or because of gene testing you can reduce your risk by 95%."

Dr. Scott Spear of Georgetown University Hospital is Hilda's plastic surgeon.

"In general, the younger the patient and the earlier the cancer is found on the first side, the wiser it is to do the other side. So for those women, the decision to think about doing something prophylactic is a lot easier than for women who are just worried about breast cancer."

Doctors stress the prophylactic choice is not for every woman, noting there are downsides to any surgery. It is an enormous decision, one that cannot be rushed. Hilda took two months to make up her mind after seeing what cancer drugs did her 90-year-old grandmother Margo.

"I really think that's an individual decision. I just needed to do everything to protect myself and make sure that I didn't have to go through chemotherapy for breast cancer. And go through taking Tamoxifen, menopause and all the side effects that come along with that."

"I feel great! I am back to, you know, my same level of activity. Maybe I would say even better than where I was."

Although a prophylactic mastectomy greatly reduces the chance of a recurrence, the procedure does not guarantee you will never get breast cancer.