Do you recommend mastectomy for triple-negative?

In a patient that is BRCA1 positive, I would discuss what the risk of a contralateral breast cancer would be in her lifetime. Because this risk by the age of 87 can be as high as 70%, in those patients bilateral mastectomy with reconstruction would be a very good option. I do not believe that a mastectomy in a BRCA1 patient is mandatory, but it's important for them to understand what their risk is. Because many of the triple-negative tumors can develop quickly, many of these patients will opt for the surgical treatment of breast removal and reconstruction to be able to move forward with their life and feel they have done everything they can surgically to reduce the change of a cancer developing in the opposite breast. The cosmetic results after current reconstruction procedures are excellent, and therefore bilateral mastectomy is not the disfiguring operation that it was 20 years ago. I always explain to my patients who choose this operation that their risk will never go to zero, as there is approximately a 2% risk of a primary breast cancer occurring in the skin flap, since not every single cell can be removed at the time of surgery.