Schechter M T
Can J Surg. 1985 May;28(3):242-4, 247.
Prophylactic procedures to prevent disease in women at high risk for breast cancer should be considered only when the benefits of prophylaxis outweigh its costs. The rational prophylactic use of mastectomy in these circumstances must await answers to several questions. First, accurate estimates of the true risk associated with these lesions must be obtained, as current estimates are imprecise and potentially biased. Second, large ongoing trials of breast cancer screening and treatment may provide effective methods of distinguishing those women at exceptionally high risk in whom such procedures may be warranted. Finally, the question of conservative surgery as an acceptable treatment for breast cancer must be settled; otherwise, the prophylactic procedure may be more invasive and disfiguring than the treatment of the disease it seeks to prevent.
仅当预防措施的益处超过其成本时，才应考虑对乳腺癌高危女性采取预防疾病的措施。在这些情况下，合理预防性地使用乳房切除术必须等待几个问题的答案。首先，必须获得与这些病变相关的真实风险的准确估计，因为目前的估计不准确且可能存在偏差。其次，正在进行的大型乳腺癌筛查和治疗试验可能会提供有效的方法，以区分那些极高危女性，对她们而言此类手术可能是必要的。最后，必须解决保守手术作为乳腺癌可接受治疗方法的问题；否则，预防性手术可能比它试图预防的疾病的治疗方法更具侵入性且更毁容。
