Prof. Janez Žgajnar, MD. PhD is a breast surgeon from the Institute of Oncology Ljubljana, Slovenia. He was one of the promotors of the oncological genetic service in Slovenia 20 years ago and is closely connected to the field as a member of the multi-professional team through daily routine and research. He is a member of the Executive committee of the Breast surgery Division of the UEMS, vice president of the Slovenian National cancer control plan, president of the Slovenian cancer society and vice president of the Slovenian Senology society.
After discovery of hereditary breast cancer related genes, several preventive strategies are in use in affected individuals and families. Prophylactic surgery is to date the most effective breast cancer risk reducing intervention, which may reduce the risk by at least 90%. The uptake of this intervention varies significantly between countries for various reasons and has changed over time. There are several technical issues to be considered related to the prophylactic surgery: timing of the intervention, type of mastectomy and reconstructive techniques. Finally yet importantly, as a physician and a member of the multi-professional genetic team the surgeon is involved in psychological aspects along with the counselling and treatment process of the affected individuals and families.