Breast Cancer Risk-Reduction

Anne Peled, M.D. is widely recognized for her unique dual training in breast cancer and reconstructive/plastic surgery. Acclaimed as one of the best reconstructive and oncologic surgeons in San Francisco, California, her work is noted for its cutting-edge approach and beautiful results. Dr. Peled specializes in developing a personalized breast cancer risk reduction for patients at high risk.
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Genetic Screening
For Breast Cancer

Genetic testing is offered to those who are likely to have an inherited mutation based on personal or family history of breast cancer or ovarian cancer. The results of genetic testing aren't always clear. A positive result means you carry a gene mutation that increases your risk of cancer and you can work with your doctor to manage that risk. A negative result may mean that you don't have the mutation or that you might have a gene mutation doctors haven't discovered yet. Your test might also identify a gene variant that doctors aren't certain about. In these situations, it's not always clear what the results mean for your cancer risk. The BRCA gene test is a blood test that uses DNA analysis to identify mutations in the two breast cancer susceptibility genes — BRCA1 and BRCA2. People who inherit mutations in these genes are at an increased risk of developing breast cancer and ovarian cancer compared with the general population. Genetic testing may also identify other genes leading to increased risk of breast cancers or other cancers.

Breast Cancer Risk Reduction

For patients who are at elevated future risk of breast cancer due to their family history or genetics (or both), a high-risk screening program is important. Our team will develop a personalized screening plan and a multi-disciplinary approach to risk-reduction for you based on your history and preferences.

Prophylactic mastectomy

A prophylactic mastectomy is surgery to remove one or both breasts to reduce the risk of developing breast cancer. According to the National Cancer Institute, a prophylactic mastectomy in women who carry a BRCA1 or BRCA2 gene mutation may be able to reduce the risk of developing breast cancer by 95%. To get the best outcome, most of Dr. Peled's patients having prophylactic mastectomies are choosing to have sensation-preserving and nipple-preserving mastectomy with reconstruction.

Prophylactic mastectomy
Before & After

Common Questions

Women can either have implant-based or flap reconstructions, or they can choose not to have reconstruction (to “go flat”). 


Depending on the procedure, recovery time can be any time from 2 to 6 weeks.

You can usually start walking within the first week, and can then slowly increase your exercise over next several weeks. You are generally back to full activity in 4 to 6 weeks.

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Procedures that are done to minimize the chance of getting breast cancer in the future are generally covered as long as patients meet the criteria of their particular insurance provider. Patients should verify their coverage with their insurance providers before surgery.

Older generation implants are thought to only last 10 years, but they are anticipating that newer ones will last from 20 to 25 years.

Saline and silicone implants have different benefits depending on the patient. Newer silicone gel implants (a.k.a. “gummy implants”) are commonly used when silicone is selected.

Most women receive smooth implants, but this is always a personalized discussion with each patient.

If you are undergoing a mastectomy, you will not be able to breast feed.

Our office has a scar management system that is customized for each patient.

Most people take 1 to 2 weeks off after surgery before they return to work, although that period can be longer if patients have additional/combined procedures involving different parts of their body.

Depending on the breast cancer procedure, varying levels of loss of sensation can occur. This is exactly why Dr. Peled has developed a new “sensation preserving mastectomy” technique, in order to preserve breast sensation during mastectomies and reconstruction. Learn More