Double Mastectomy

November 12, 2012

Double Mastectomy

A double mastectomy is a procedure which surgically removes both breasts. This is carried out to reduce or prevent the risk of breast cancer.

One of two procedures is carried out. A total mastectomy involves removal of the nipple and the whole breast. A subcutaneous mastectomy leaves the nipple intact and the breast tissue is removed. Many doctors recommend a total mastectomy. This is because more tissue is removed compared to a subcutaneous mastectomy and also a total mastectomy offers protection against the development of cancer in any breast tissue which remains.

Women who may be at a higher risk of the development of breast cancer are:

  • Women with a family history, particularly if the mother, daughter or sister received a diagnosis before they were 50 years of age.

  • Women who have tested positive for mutations or changes in particular genes such as BRCA1 or BRCA2

  • Women with lobular carcinoma in situ may consider a double mastectomy as this condition increase the risks

  • Women who have had radiation therapy in the area of the chest before they were 30 are at a higher risk of breast cancer developing. Women who have been treated for Hodgkins Lymphoma are included in this category.

Any surgery has risks and complications which may arise such as infection or bleeding. It is very important for women who may be considering a double mastectomy to speak with their doctor about any risks or concerns they have. They should also speak with the doctor about the chances of breast cancer developing whether a mastectomy is carried out or not. A double mastectomy can have a psychological effect on women due to the change in their body image and it is irreversible. Women should talk with their doctor about their feelings regarding a mastectomy and ask about alternatives. In some cases women have requested a second opinion from another doctor to help with their decision.

Regular check-ups which include an examination of the breasts, mammograms and carrying out breast self-examinations on a monthly basis may be considered as an alternative to surgery. By carrying these out it means detection of breast cancer may be found early.

It may be women are prescribed raloxifene or tamoxifen. These medications reduce the chances of breast cancer developing in women who are at high risk.

Reconstruction of the breasts is a plastic surgery procedure where the breast is rebuilt. Women who have decided to have a double mastectomy can make the decision to have reconstruction surgery. This decision is normally made at the same time as the mastectomy. Although some women decide on this at a later time.

Women are monitored very carefully after receiving reconstructive surgery. This is to check and treat any complications which may develop, such as the implant having moved, infection, or a firm, fibrous shell or scar tissue forming around the implant which is caused by a reaction to the implant from the body. This is also known as contracture. If a woman has had reconstruction of a tissue flap she may want to find out about physical therapy. This can help in adjusting to the limited exercise and activity which can be carried out after this surgery. Part of the post-operative follow-up is routine breast cancer screening because the chance of cancer developing has not been eliminated.

Women who are having mammograms should inform the radiologist they have had an implant. It may be required to put procedures in place to avoid causing damage to the implant and also to ensure an accurate mammogram is carried out. Women who have had reconstructive surgery on both breasts should speak with their doctor to find out if mammograms are still required.

The FDA (United States Food and Drug Administration) regulate breast implant usage. They can also supply more detailed information.

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