Charles E. Cox, MS, FACS

Ghosh and Hartmann present an excellent overview on the risk reduction that prophylactic mastectomy offers the high-risk patient. Dr. Hartmann and the Mayo Clinic remain leaders in this field. As cited in their recent series, the risk of developing breast cancer is reduced 89.5% to 100% in high-risk women who choose to undergo prophylactic mastectomy.[1] In the same year, Meijers-Heijboer et al supported these findings, documenting a 100% relative risk reduction.[2] The fact that prophylactic surgery offers a dramatic reduction in the risk of breast cancer to high-risk patients appears unquestionable.

Developed initially for the treatment of malignant melanoma, lymphatic mapping and sentinel lymph node biopsy have recently been introduced into the treatment of early breast cancer. In breast cancer patients, harvested