Only One-Third of Women Undergo Preventive Mastectomy – A New Project Aims to Raise Breast Reconstruction Awareness

One in eleven women will develop breast cancer in her lifetime, making it one of the most pressing public health issues. Women with hereditary mutations in the BRCA1 and BRCA2 genes face up to a tenfold higher risk. Yet, experts warn that despite the availability of preventive measures like extended screening and risk-reducing surgery (i.e. preventive mastectomy), they remain underused.

“In the Czech Republic, only 25–33% of women who know they carry this mutation and are thus at increased risk of breast cancer decide to have the surgery,” says Associate Professor Libor Streit, Head of the Burn and Plastic Surgery Clinic at University Hospital Brno and the Faculty of Medicine, Masaryk University. In contrast, countries like the USA or the UK report uptake as high as 40%, despite Czech oncology prevention programs being among the best in the world.

What factors influence a woman’s decision to undergo preventive mastectomy? What are their main concerns? Can publicized stories of celebrities who had the surgery serve as inspiration? These are some of the questions addressed by the international project CHOICE (Comprehensive Health Options and Information for Cancer Education), which aims to improve breast cancer literacy and support informed decision-making.

“Public awareness around breast cancer has many layers. When it comes to preventive mastectomy, the focus is often on the removal of breast tissue, while reconstruction – typically performed immediately after – is overlooked. Yet reconstruction is a crucial part of the process and significantly affects post-operative quality of life. Most women in the Czech Republic wouldn’t choose the surgery unless breast reconstruction was a realistic option,” explains Streit. His clinic performs such procedures regularly.

He also addresses concerns that have recently arisen due to media coverage of so-called “breast implant illness” – a set of various health issues some women associate with silicone breast implants. “These reports have made women more cautious and interested in tissue-based reconstruction. While complications related to implants do occur, they are very rare. In my career, I’ve encountered only two or three such cases, but the media coverage was so strong it gave the impression these are common problems,” he adds.

The CHOICE initiative, involving Masaryk University, the Institute of Biostatistics and Analyses, and experts from Portugal and Greece, aims to improve health literacy not only among patients but also among healthcare professionals – particularly plastic surgeons and oncologists. Alongside large-scale international surveys to better understand how women perceive breast cancer, the project will develop an educational web portal featuring a detailed health literacy glossary and an interactive virtual library. Healthcare providers will also benefit from new training programs to improve communication with patients.

“I believe our project will raise awareness about preventive surgery and breast reconstruction, help women access reliable information, and alleviate their fears about preventive mastectomy,” concludes Streit.