Home > Thinking About Bilateral Mastectomy for Early-Stage Breast Cancer
For years, studies have shown that for early-stage breast cancer, women who have breast-conserving surgery (lumpectomy) followed by radiation treatments live just as long as women who have mastectomy. This was good news for women who wanted to avoid having their whole breast removed.
In recent years, a growing number of women with early-stage cancer have chosen to have both the affected breast and their healthy breast removed. Removing both breasts is called a bilateral or double mastectomy.
Each woman facing breast cancer has to decide which treatment is right for her. But you don't have to make a decision right away. You can take some time to think about your options and what matters most to you.
Most experts do not recommend bilateral mastectomy for early-stage breast cancer. This is because:
The risk of a new cancer in the breast is already small. If a new cancer occurs, it is more likely to appear somewhere else in the body.
Having both breasts removed is recommended for women at very high risk of breast cancer. For example, those who have tested positive for a breast cancer (BRCA) gene change are at very high risk. These high-risk women often have their breasts removed before they get breast cancer. This is called a preventive or prophylactic mastectomy. It can greatly lower their risk of cancer.
Having cancer in one breast does not put a woman in this very high-risk group. Your doctor can help you understand your own personal risk of a new cancer and the best way to manage that risk.
Women may have personal reasons for choosing to remove both breasts. These may include:
Bilateral mastectomy has some benefits. For example, with this surgery there is:
The surgery also has some downsides. Bilateral mastectomy:
Some surgeons may not agree to remove both breasts unless a woman is at high risk of a second breast cancer.
Insurance companies that offer mastectomy coverage must also provide coverage for reconstructive surgery after mastectomy. But there is a chance they may not pay to remove or reconstruct a breast that does not have cancer.
Most women are satisfied with the results of the surgery, but some women regret having it. Some find that having their breasts removed affects how they feel about themselves. And they may not gain the peace of mind they had hoped for. In general, women are more satisfied when they feel well-informed and take an active role in this decision.
Be sure to give yourself time to think through both the medical facts and how you feel about your choices. This is a very personal decision. Your feelings are as important as any other factor.
No one else can tell you what's right for you. But it may help to discuss your choices with people who know you well.
If you're thinking about breast reconstruction, it's a good idea to meet with a plastic surgeon. You can ask to see photos and talk to women who have had the surgery.
It might also help to ask yourself some questions, such as:
Kurian AW, et al. (2014). Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998-2011. JAMA, 312(9): 902-914. DOI: 10.1001/jama.2014.10707. Accessed August 27, 2015.
ByHealthwise StaffPrimary Medical ReviewerKathleen Romito, MD - Family MedicineMartin J. Gabica, MD - Family MedicineSpecialist Medical ReviewerLaura S. Dominici, MD - General Surgery,
Current as ofMay 3, 2017
Current as of:
May 3, 2017
Kathleen Romito, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine & Laura S. Dominici, MD - General Surgery,
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