Women who are at high risk of breast cancer who may wish to consider prophylactic mastectomy after weighing other preventive options for breast cancer include those with a strong family history of breast cancer (especially if the breast cancer was diagnosed among several first-degree relatives, mother or sisters, before age 50),those who have tested positive for the BRCA1 or BRCA2 gene mutations and those who have a personal history of breast cancer and are at high risk for a recurrence. The gene discussed is BRCA1; the disease is breast carcinoma.