Unilateral vs Bilateral Mastectomy

A mastectomy can involve the removal of either one breast (known as unilateral or single mastectomy) or both breasts (referred to as bilateral or double mastectomy). When considering whether to opt for a bilateral mastectomy, your medical team may suggest this approach if cancer is detected in both breasts or if you possess a heightened susceptibility for a secondary breast cancer due to a strong familial history of breast cancer or an inherited genetic mutation like BRCA1, BRCA2, or PALB2. Preventive (prophylactic) bilateral mastectomies are also performed for individuals at elevated risk who haven’t yet received a breast cancer diagnosis. In cases where early-stage cancer affects only one breast, women often confront a choice between a unilateral and bilateral mastectomy, a decision that’s frequently intricate. Some women select a bilateral mastectomy even when a unilateral option is viable, driven by concerns about potential future development of a new breast cancer in the unaffected breast, apprehension regarding ongoing surveillance demands (via breast imaging like mammograms) and potential future biopsies, as well as aesthetic considerations pertaining to chest appearance post-reconstruction or removal of a solitary breast.

Over the past two decades, a rising number of women in the United States diagnosed with early-stage breast cancer in one breast have been electing to undergo a bilateral mastectomy. The removal of the non-cancerous breast is termed contralateral prophylactic mastectomy. However, some medical professional’s express apprehension that an excessive number of women are selecting contralateral prophylactic mastectomy under the assumption of higher risk for breast cancer in the other breast than the actual probability. Studies reveal that for women with an average risk profile, removing the non-affected breast doesn’t enhance overall survival, as the likelihood of cancer developing in the other breast is approximately 1% or lower annually. Engage in discussions with your healthcare team to determine the most suitable approach for your specific situation. Making an informed choice about your treatment necessitates a clear understanding of your factual risk regarding cancer recurrence or the emergence of new cancer.