Your Guide to Understanding a Double Mastectomy

In In The News by Barbara Jacoby

From: healthline.com

A double (bilateral) mastectomy is the surgical removal of both breasts. This procedure is used to treat breast cancer or to reduce the risk of breast cancer in people with a high risk.

What is a double mastectomy, and why have one?

Double mastectomy is the surgical removal of both breasts. The purpose is to:

  • remove breast cancer
  • reduce the risk of cancer for those who may be at high risk for breast cancer
  • allow for symmetry
  • avoid ongoing surveillance imaging if you’re at a high risk of breast cancer

Your doctor may recommend a double mastectomy if:

  • You have breast cancer in both breasts: If the stage and characteristics do not make lumpectomy an option, you may have a double mastectomy.
  • You have a high risk of contralateral breast cancer in the second breast: If you have cancer in one breast and have a very high risk of getting a second breast cancer in the remaining breast, you may choose a double mastectomy. A high risk includes having the BRCA1 or BRCA2 gene mutation, or a strong family history of breast cancer.
  • You’re not at high risk for getting a second breast cancer, but you want to avoid worrying about the possibility: You may choose to have the second breast removed, as well as the one with cancer. The medical term for having a second healthy breast removed is contralateral prophylactic mastectomy (CPM). However, there’s no overall survival benefit for removing the contralateral breast, as breast cancers do not spread to the other breast.
  • You want to reduce the risk of developing cancer in the future, even though you do not currently have breast cancer: A bilateral risk-reducing mastectomy is usually done only if you carry one of the genes linked to breast cancer risk, or you have a strong family history of breast cancer.

Are there benefits to having both breasts removed?

There may be some benefit to removing both breasts if you are at a very high risk of getting another breast cancer. (If you carry a BRCA gene mutation or have a strong family history of breast cancer, for example.)

The benefit is less clear for women who are not at high risk, as the risk of getting cancer in the other breast is usually lowTrusted Source, according to the American Cancer Society (ACS).

Even so, the number of women choosing CPMs tripled during the first decade of this century and is continuing to rise.

The American Society of Breast Surgeons (ASBrS)Trusted Source discourages CPMs for average-risk females with cancer in just one breast or for males with breast cancer. They point out that CPM surgeries have twice the complication rate as unilateral mastectomy, and the recovery time is longer.

The ASBrS recommends CPM as a good option to consider for female BRCA carriers and those with a strong family history of breast cancer. CPM is rarely a good choice for male cancer, even with the BRCA gene, they say.