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Options for High-Risk Women

While regular digital mammograms and clinical exams are enough for most women, some require more attention and follow-up care to safeguard their breast health. To that end, MedStar Health offers high-risk services by dedicated medical oncologists and knowledgeable nurse practitioners who specialize in breast health.

These services are designed for women with:

  • A family history of breast cancer
  • Knowledge or suspicion that they carry the breast cancer mutation genes, BRCA1 or BRCA2
  • A previous abnormal biopsy demonstrating atypical cells or lobular carcinoma in situ

If you are a woman who is concerned about genetics and breast cancer risk, you may be considering chemoprevention or a prophylactic or risk-reducing mastectomy. Deciding to pursue these strategies is not a decision to be made lightly, and our breast surgeons and other breast providers are experienced in talking about it with women and their families.

Read more about these options below.


At one time, the only thing a physician could offer a high-risk woman was increased attention so that cancer could be detected at the earliest possible sign. But thanks to recent research—some of it conducted at MedStar Georgetown’s own Lombardi Comprehensive Cancer Center—powerful new drugs such as tamoxifen and raloxifene reduce the risk of cancer development in highly susceptible women by as high as 87 percent. A new class of therapy, aromatase inhibitors, also shows promise, but, at present, are not being used for chemoprevention outside of a clinical trial.

Prophylactic Mastectomy

If you have a family history of breast cancer or you carry the BRCA-1 or BRCA-2 gene mutations, you may consider having a risk-reducing or prophylactic mastectomy. This surgery removes your breasts to decrease the chances that you will develop breast cancer.

Despite its significant reduction in breast cancer risk, a prophylactic mastectomy is not a guarantee that you will not develop breast cancer.

Many women feel a sense of relief by taking control of their risk, but there are potential consequences to consider.

  • The surgery is irreversible, although many women also decide to have breast reconstruction along with a prophylactic mastectomy.
  • You can't breastfeed from the affected breast(s).
  • You lose feeling and sensitivity in the affected breast(s).
  • Many women experience changes in the way they feel about their body image.

If, after weighing your options carefully, you decide to pursue this option, MedStar Health can offer you the best care available. Our breast surgeons can help find the right option for you.