Mom had breast cancer, i used to drink a lot, i took birth control, etc. i feel like my risk of breast ca is incredibly high. prophylactic mastectomy?

Not necessarily : Alcohol consumption over certain level may increase your risk to some degree and obviously family history does too but I would not go crazy thinking it's "incredibly high". I suggest you talk to your doc and ask to see a specialist in risk assessment to get a better estimate of your risk and maybe some tips on how to reduce it. Don't live in fear, my friend. Best to you.

Breast Cancer Risk: The National Cancer Institute has an interactive breast cancer risk assessment tool. Check it out at: http://www.cancer.gov/bcrisktool/

Not necessary: it is good that you quit drinking. I would suggest you to be active, regular exercise. consume healthy and well balanced diet. avoid obesity. don't drink alcohol and don't smoke. majority of breast cancer is sporadic and only minority is hereditary/familial. prophylactic mastectomy is optional if your risk for breast cancer is very significant for instance if you carry the BRCA 1/2 gene mutation.

Speak to doctor: I recommend you find a breast center in your area and get a risk assessment. They will also determine if you are a candidate for genetic testing.