Bilateral breast reconstruction and the role of prophylactic mastectomy.

Bilateral breast reconstruction may be indicated in women with bilateral cancers, those with unilateral cancer and a high risk of developing a contralateral cancer, or in women who choose bilateral prophylactic mastectomy. Numerous options for reconstruction are available, including TRAM flaps, latissimus dorsi flaps, and saline or silicone gel-filled implants. The discoveries of the BRCA1 and BRCA2 gene mutations and their implications for breast cancer risk have led to renewed interest in prophylactic mastectomy. Recent studies have confirmed that prophylactic mastectomy is effective in reducing breast cancer risk, but the decision to proceed with prophylactic mastectomy must be made on a case-by-case basis.