James W. Jakub, MD

The management of in-transit metastases is challenging, since the treatments and extent of disease vary greatly based on the number, depth, location, and distribution of lesions, and on their biological behavior.

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.