Breast cancer Forum

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Breast cancer

 Treatments for breast cancer

Should I go flat? BRCA1 positive

avatar tfriel

avatar Somya.P

Hi Andy,

First let me say I'm sorry you have to consider this at all. It is hugely difficult and sometimes tough to get real answers from doctors. Second, look carefully into the real prophylactic effects of this choice. Do some researching on this option. From what I have read, it may not prevent BC despite your sacrifice. Finally ask tons of questions and know the options. Doctors can be short and brief with you about this decision when it is a life altering choice. Don't be afraid to ask and request explanations. If they don't give you a response, find another doctor. Make sure you trust your surgeon and request a plastic surgeon for your close. Here are a few things I've learned from friend who went flat...doctors don't always believe you when you say you want to go flat so they do things that will make it easier to change your mind but make being flat difficult. "dog ears" under your arms can be left that are annoying and prevent you from enjoying the choice. These allow for future implants and better aesthetic outcomes but for those who want and will stay flat it means deciding on a second surgery to remove them. For reconstruction, you can use implants or your own fat or a combination. Look into all these choices. If you are an athlete, being flat could be a great choice. Why request a plastic surgeon? It's the difference between having huge jagged scars and a very finely sewn nearly invisible line. It's worth the request. Surgeons just sew stuff together normally, Plastic surgeons are taught to sew layers together so the whole system lays flat. Like sewing five layers of fabric results in a bunched up seam, while sewing each layer individually can be less lumpy and smoother. Use the scar softener tapes found at walgreens or amazon to keep the scars soft. My doctor didnt even know what these were. They work. I learned about them from another cancer survivor. Here is ACS article on prophylactic mastectomy. https://www.cancer.org/cancer/types/breast-cancer/risk-and-prevention/preventive-surgery-to-reduce-breast-cancer-risk.html#:~:text=A%20prophylactic%20mastectomy%20can%20lower,go%20on%20to%20become%20cancer. And an article about going flat https://www.cancercenter.com/community/blog/2023/07/going-flat-after-mastectomy#:~:text=Some%20of%20the%20most%20common,complications%20and%20other%20health%20problems

Preventive Surgery to Reduce Breast Cancer Risk

For some women who have a very high risk of breast cancer, preventive surgery, such as a prophylactic mastectomy, may be an option to lower their risk.

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