So why would a woman choose to have a mastectomy not a lumpectomy?

Well, the only medical reason to have a mastectomy rather than a lumpectomy and radiation is if the tumour is so big in comparison to the size of the breast that you can't get it out any other way. Apart from that some women choose mastectomy because they don't want to have radiation or they live a distance from where they can get radiation.

Radiation is five weeks and so it can be a little bit of a time thing, but that is really one of the only arguments. Unfortunately, even today in 2001 there are doctors who are really not giving women the options. They say, "well, you can have a lumpectomy and radiation if you want but if you were my wife or you know if it were up to me I would do a mastectomy." And of course when women hear that they think, oh well, he knows something or she knows something I don't know and they end up choosing the mastectomy, thinking somehow they are getting a better deal.

Do you think that preventative mastectomy is necessary these days or, let's say, in a few years time? Should a girl who has a genetically very high risk of breast cancer be thinking of a preventative mastectomy?

It is only very recently that we have gotten data on preventative mastectomy that show that it actually does some good. Prior to that we really didn't know. It looks like it will prevent about ninety percent of breast cancers in women who are high risk.

But it is a very crude way to prevent breast cancer ... My hope is [that] with some of the newer research we will be able to figure out much better ways to prevent breast cancer. I think we are in a little time period now where it is all we have but I doubt that this will be what we will be using in five years.