Question: If I have breast cancer in my family, should I consider having my breasts removed?
Answer: What about a personal decision of a prophylactic mastectomy -- obviously a major life-changing, irreversible decision? There are some women for whom that decision seems to be a very comfortable one. They've seen the occurrence of breast cancer in their family. Perhaps they've had genetic testing; they have been found to be a carrier of the mutation. So they have a good idea of what their risk actually is. For whatever reason in their immediate family, their values, their personal goals -- they want to have their risk reduced significantly; they want to go this route.
What I usually tell women is, I think this is one of the most personal decisions that there is. It's a decision that needs to be taken over time. A time not to make such a decision might be someone who has just found out about a family history of cancer; perhaps they weren't in touch with their family. They find that there is significant cancer there. Maybe they've been tested. They find they're a mutation carrier and over the course of a very short period of time they're facing this decision.
Personally, I don't think that's the way to do this. I think it really needs to evolve over time. Take advantage of multiple opinions. Talk to women who have done this. Certainly talk to your immediate family -- your spouse, your partner. Really think about it, and take six months at a minimum to think this through. I think if it's the right decision for someone, you will know that in yourself. And then we can talk further about it.