Bilateral Mastectomy
Bilateral Mastectomy
What is a Bilateral Mastectomy?
Bilateral mastectomy is also known as double mastectomy. It is a surgical procedure in which both of the breasts are removed. This type of mastectomy can be performed as a treatment option for breast cancer as well as a preventive measure for individuals who have a high risk of developing the disease, such as those affected by the BRCA gene mutation [Link to BRCA Gene] or other contributing factors.
A bilateral mastectomy can be a total mastectomy, [Link to Total Mastectomy] where all of the breast tissue is removed, including the nipple, areola, and skin, and it may remove some or all of the lymph nodes. Alternatively it may also spare the nipples [Link to Nipple-Sparing Mastectomy] and some of the skin. [Link to Skin-Sparing Mastectomy]
What are the Benefits of a Bilateral Mastectomy?
A bilateral mastectomy is a common treatment option for individuals diagnosed with breast cancer. While the decision to undergo this surgery can be daunting, it does have significant benefits that can improve both physical and emotional well-being.
- Reduced Risk of Cancer: If you have a high risk of developing breast cancer due to your family history, [Link to Family History] BRCA gene mutations, or other reasons, choosing to have a double mastectomy as a preventative measure will reduce the risk of developing cancer. Depending on your own personal circumstances and health concerns, you may choose to have one or both breasts removed.
- Reduced Risk of Cancer Recurrence: In women already affected by breast cancer, by removing the affected breast tissue, a bilateral mastectomy significantly reduces the risk of cancer recurrence. This can provide peace of mind and confidence in knowing that steps have been taken to prevent further spread of malignant cells.
- Improved Survival Rates: Studies have shown that individuals who undergo a mastectomy as part of their treatment plan have better survival rates compared to those who opt for other treatments [Link to Treatment Options] or no surgery at all. Removing the tumor and breast tissue on both sides through surgery can effectively eradicate cancer cells and improve long-term outcomes.
- Enhanced Aesthetic Results: For many individuals, undergoing a bilateral mastectomy can lead to improved aesthetic results compared to other surgical options like lumpectomy or unilateral mastectomy. With advancements in reconstructive surgery techniques, patients can enjoy greater final symmetry and natural-looking results following reconstruction surgery. [Link to Breast Reconstruction]
- Psychological Benefits: Dealing with a breast cancer diagnosis and undergoing treatment can take an emotional toll on women. Choosing a bilateral mastectomy may help you feel empowered by taking control of your health and making proactive decisions about your treatment plan. Additionally, feeling comfortable with your appearance after reconstruction surgery can boost your self-confidence and overall well-being.
The benefits of a bilateral mastectomy extend beyond physical health improvements to include emotional well-being and quality of life enhancements for many women facing a breast cancer diagnosis. Consulting with your doctors about your individualized treatment options is critical in determining the most appropriate course of action based on your unique circumstances and preferences.
Who is a Good Candidate for a Bilateral Mastectomy?
A woman may choose to have a mastectomy as a preventative measure because she is in a high-risk category for developing breast cancer. In that case, she would be most likely to have a bilateral (double) mastectomy. However, there are certain factors that can make someone a good candidate for removing only one breast:
- High Risk for Genetic Mutations: Individuals who carry certain genetic mutations, such as BRCA1 or BRCA2, which increase their risk of developing breast cancer may opt for a prophylactic bilateral mastectomy [Link to Prophylactic/Preventative Mastectomy] to reduce their risk as much as they possibly can.
- Family History of Breast Cancer: Individuals with a strong family history of breast cancer, for example multiple close relatives like a mother or sister, who have been diagnosed with breast cancer, you may be at an increased risk of developing the disease yourself. In these cases, doctors may recommend a bilateral mastectomy as a preventive measure to reduce your risk.
- Cancer in Both Breasts: If you are diagnosed with cancerous or pre-cancerous tissue in both breasts, you may opt for a bilateral mastectomy to eradicate the diseased cells and improve your long-term outcome.
- Previous Radiation Therapy: If a person has already undergone radiation therapy for another condition (such as lymphoma), they may be at increased risk for developing secondary cancers and could benefit from a double mastectomy.
What Should I Expect From My Surgery?
During a bilateral mastectomy, the surgeon will remove the breast tissue from both sides of your chest. This may also include the nipples, areolas, and some or all of the lymph nodes on both sides. The nipple and areola may also be retained during this procedure, depending on the extent of the disease or the patient's personal preference.
After undergoing a bilateral mastectomy, you may choose to undergo reconstructive surgery to restore the appearance of your breasts. This can take place either immediately following the mastectomy in one surgery or at a later date, once recovery from the mastectomy is complete.
Before Surgery
Before your surgery, you'll have a meeting with your surgical team to go over the details of your operation. This is a great opportunity to ask any questions you may have and ensure you fully understand the procedure, its purpose, associated risks, and any alternative treatments available.
It's important to consider whether you may need radiation therapy after your surgery, as it can affect your options for breast reconstruction. Some patients may know in advance that radiation will be part of their treatment plan, while for others, this decision may depend on the results of the mastectomy. You may have a consultation with a radiation oncologist before or after surgery to discuss the potential benefits and risks.
Your healthcare team will provide you with specific instructions to prepare for surgery, which may include:
- Informing your healthcare team about any medications, vitamins, or supplements you're currently taking, as certain substances may interfere with the surgery.
- Stopping certain medications, such as aspirin or other blood-thinners, as advised by your healthcare team.
- Following guidelines regarding fasting before surgery, which may involve refraining from eating for several hours beforehand and only drinking liquids up to a certain time.
- Planning for post-surgery arrangements, such as whether you'll need to stay in the hospital overnight or go home the same day. Arrange for transportation if you're discharged the same day and prepare a bag with essentials for your hospital stay, including toiletries and items for comfort and entertainment.
During Surgery (Procedure Overview)
A mastectomy will normally involve staying in the hospital for at least one night, depending on the type of surgery you will be having. The procedure can vary based on your personal circumstances and your doctor's methods.
- You'll be asked to change into a gown.
- An IV (intravenous) line will be inserted into your arm or hand to give you medication that will help you relax and put you to sleep during surgery.
- You'll lie on your back on the operating table.
- Your vital signs, like heart rate and blood pressure, will be monitored throughout the surgery.
- The skin around the surgical area will be cleaned with a sterile solution and an incision will be made in the first breast. The type of cut will depend on the type of mastectomy you're having.
- The breast tissue will be carefully removed.
- Some or all of the nearby lymph nodes may be taken out after the breast tissue is removed.
- The same procedure will be repeated on the other side.
- If you're having breast reconstruction at the same time, a plastic surgeon will perform the procedure after the mastectomy.
- The removed tissues will be sent to the hospital lab for examination.
- Drainage tubes may be inserted into the area.
- The incisions will be closed with stitches or adhesive strips and a sterile bandage or dressing will be applied over the site.
After Surgery & Recovery
During your hospital stay, you'll be taken to the recovery room after the procedure. There, you'll be closely monitored until your vital signs like blood pressure, pulse, and breathing are stable, and you're awake and alert. Once you're stable, you'll be moved to your hospital room.
Typically, you'll stay in the hospital for 1 to 3 days after a mastectomy, depending on the extent of the surgery and whether you had breast reconstruction at the same time.
Once you're home, it's important to keep the surgical area clean and dry, following your doctor's instructions. You'll also need to care for the drainage tubes, which are usually removed after about 2 weeks at your first follow-up exam.
You may experience some pain, which can vary depending on the surgery. Your healthcare team will recommend pain relievers, but be cautious about taking aspirin or certain other pain medicines that may increase the risk of bleeding.
If lymph node removal was part of your mastectomy, your doctor may recommend exercises to help prevent swelling and stiffness in your shoulders and arms. These exercises should be started slowly and progressed gradually.
You can typically resume normal activities in a few weeks, but you should avoid strenuous activities in the meantime. Your surgeon will advise you on when you can drive again and return to work.
If you're having difficulty coping with your recovery, you may find it helpful to speak to your loved ones or to join a support group for assistance. This can help you cope with the emotional aspects of undergoing this type of surgery.
Contact your doctor if you experience fever, chills, increased pain, swelling, or any other concerning symptoms after surgery.
Contact us today [Link to Contact] for a confidential conversation by video call directly with one of our expert surgeons. We are more than happy to discuss your treatment options with you if you have already had a cancer diagnosis or are at a high risk for contracting the disease.