What do surgeons need before performing preventative simple mastectomy?

Appropriate reason: Removing a breast is not an insignificant thing and should only be done for an appropriate indication (i.e. Appropriate high risk). Beyond this, basic screening should have been done in a recent interval - no one likes surprises. The patient should be a reasonable surgical candidate.

An Informed Patient: Before considering a prophylactic mastectomy, it is necessary to understand one's risk of developing breast cancer. This is best addressed by a genetic counselor, supplemented by blood testing. Next, it is important to understand the different surgical options available, especially relating to simultaneous reconstruction. Lastly, a recent mammogram is necessary to check for an occult cancer.