Prophylactic mastectomy and inherited predisposition to XXXX .

@entity1 @entity0 @entity5345 @entity5 @entity2674
Relative to her risk of @entity0 , the @entity1 with a @entity5345 or @entity2674 gene mutation can be managed either by intensive screening (with or without chemoprevention) or by prophylactic mastectomy. Although it would be preferable to avoid prophylactic surgery, the current level of screening technology and the rudimentary state of chemoprevention do not guarantee a good outcome with intensive surveillance. A review of the currently available data was undertaken to determine the efficacy of prophylactic surgery, intensive screening, and chemoprevention. An attempt then was made to extrapolate the efficacy of the various approaches to the management of @entity1 who carry @entity5345 or @entity2674 gene mutations. Intensive surveillance may not detect @entity0 at an early, curable stage in young @entity1 with @entity5345 or @entity2674 gene mutations because the growth rate of the @entity5 in these @entity1 most likely will be rapid and the density of the breast tissue may compromise detection. Chemoprevention is in its infancy, and its efficacy in this population is unknown. Conversely, prophylactic surgery may not be completely effective in preventing @entity0 . The authors are hopeful that sometime in the next decade advances in chemoprevention, screening technology, or @entity0 treatment will make mastectomy obsolete. However, for the time being prophylactic mastectomy has attributes that make it an alternative for this population that must be considered. Careful discussion of all options is essential in the management of these @entity1 .
