Defining Lifetime Risk Thresholds for Breast Cancer Surgical Prevention

At what level of lifetime breast cancer risk is offering risk-reducing mastectomy cost-effective compared with nonsurgical alternatives for breast cancer prevention?In this economic evaluation of a simulated cohort of women at varying risks for breast cancer, undergoing risk-reducing mastectomy was found to be cost-effective for women in the UK aged 30 to 55 years with a lifetime breast cancer risk greater than 35%, compared with risk-stratified breast cancer screening and medical prevention (tamoxifen or anastrozole).These findings support changing current practice to expand risk-reducing mastectomy access beyond the traditional , , and pathogenic variant carriers to individuals at a 35% or higher lifetime risk.

Corresponding Author: Ranjit Manchanda, MD, PhD, Centre for Cancer Screening, Prevention r.manchanda@qmul.ac.uk).

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