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Already operated on the left breast in 2020, which she had removed following cancer, Alice Detollenaere, the companion of Camille Lacourt, former star of the Olympic pools, has her right breast removed as a preventive measure today. What is a preventive mastectomy? What are the possibilities of reconstruction following this surgery? The answers of Pr Lantieri, plastic and aesthetic surgeon at the European Georges-Pompidou Hospital in Paris.
Doctissimo: When should a preventive mastectomy be used?
Professor Laurent Lantieri: Preventive mastectomy is offered in two cases: to women who have already had breast cancer and those who have never had it but who in all cases are carriers of genes favoring the risk of developing breast cancer. or ovary. These are women who carry a gene called BRCA1, BRCA2 or others that are also rarer, and who have a modification and which we know significantly increases the risk for these women: more than 70% risk of developing breast cancer. breast of an aggressive form or more 10% for ovarian cancers, which are usually infrequent.
In addition, these cancers, for the breast, are what are called triple negative cancers: without hormone receptors, without response to herceptin (a treatment for breast cancer) and with a poor prognosis.
Is this common practice?
Professor Laurent Lantiéri: It is a preventive measure, which is offered to the patients concerned. Preventive mastectomy can concern healthy people, who are not sick and have not yet had cancer, but who are at higher risk. This is the only preventive measure that can be considered, because surveillance by imaging by doing MRIs or close mammograms would not be enough. The cancer could appear between examinations and be dazzling, or detected early but the disease would already be established. Be that as it may, it is an approach that is offered to the patient who will be the only one able to choose.
In any case, it’s different than for a patient who has cancer and needs to be treated. Because in this case, it is a treatment above all and the reconstruction will come after the ablation. However, in the case of cancer, the skin is removed, the tissues are damaged… Reconstruction will always be more difficult than preventive, or the skin sheaths, which is the skin of each of the breasts, can be preserved.
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What are the possibilities of reconstruction?
Professor Laurent Lantiéri: We operate and reconstruct the breasts at the same time. The mammary gland is removed, then prostheses are placed if the patient wishes. It is also possible to carry out a reconstruction by flaps, by taking tissues and fat elsewhere on the patient’s body, in the area of the belly in particular. It is a surgery covered by Social Security, with the possibility of exceeding fees depending on the surgeon and also, patients must know that they must request a prior agreement from Social Security, whatever the reason. surgery (preventive or curative). You should also know that this remains a fairly heavy operation, which has a significant risk of complications. However, reconstruction is essential for a woman, because we know that without reconstruction, the quality of life will be impacted in the long term. Whereas, on the contrary, according to the studies that have been carried out on these reconstructions, the results show that a reconstructed woman will have the same quality of life as a woman who has never had breast cancer, ten years after his operation.