Double mastectomy: do you know when it is necessary to remove both breasts?

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Surgery is indicated to treat and prevent breast cancer. Learn about the history of the biomedical doctor who performed this procedure at just 33 years old

A mastectomy is a surgical procedure that involves removing one (unilateral) or two (bilateral) breasts to treat or even prevent breast cancer. The second option, also known as double mastectomy, is the least used; but it is the one that tends to cause more doubts and insecurities in patients.

After all, receiving the indication to remove both breasts can sound a little aggressive, even if it only happens in specific cases. “This surgery is only indicated if the patient has high risk of developing breast cancerespecially when he already has a mutation of the BRCA1 and BRCA2 genes”, explains Carlos Machado, a general practitioner specializing in Preventive Medicine.

This means that a double mastectomy is usually recommended when the tumor has already reached both breasts or if there is a high chance that it will spread to the other breast – in this second case, it is also considered a preventive mastectomy.

Despite being a difficult decision, according to the National Cancer Institute, mastectomy reduces at 90% to 95% the risk of people with a genetic mutation or a strong family history to develop breast cancer. And there are different ways to perform this procedure, the most common of which involves removing the nipple, areola, pectoralis major muscle and skin.

Photo: Getty Images | Sophie Mayanne

Photo: Getty Images | Sophie Mayanne

Double mastectomy at age 33

In June 2019, biomedical Lorena Soares experienced a challenging situation, to say the least. Diagnosed with hormonal subtype breast cancer, she had to undergo a double mastectomy at just 33 years old.

The tumor, already advanced in size, was in only one breast. However, the other breast ended up being removed preventively, to prevent the disease from developing again even after treatment.

For working with health, Lorena says that receiving the diagnosis of breast cancer was not the most difficult part. “As I am from the area, the discovery of the disease made me understand that it was possible to treat and take care of myself. So, it wasn’t that shocking”, recalls the biomedical doctor.

Oral chemotherapy and radiotherapy – methods that are also part of breast cancer treatment – were also not a problem. The main challenge, however, began after the breast removal surgery. “I had every chance and fought bravely, but it was a complex recovery”, he vents.

Possible sequelae of double mastectomy

For the biomedic, the most complicated moment with breast cancer was dealing with the treatment sequelae. Between early menopause and the body changes that occur during the use of therapies that act in tumor remission, double mastectomy still causes other side effects, such as:

  • Pain or tenderness in the area of ​​the surgery;

  • Swelling;

  • Bruises;

  • Accumulation of fluid and/or blood in the wound;

  • Chest or arm numbness (may be permanent or temporary)

  • Post-mastectomy pain syndrome, characterized by persistent pain, burning, or stabbing in the chest wall, armpit, and/or arm.

For people who dream of motherhood and breastfeeding, a double mastectomy can be an even greater challenge, especially when the total removal of breast structures, including the mammary glands and ducts. This is because the person is unable to produce milk and, consequently, to breastfeed.

Self-esteem is also greatly affected, even harming the patient’s sex life. So the whole process is not easy. “I had to learn to resignify and find a new meaning for this whole situation”, reveals Lorena. Therefore, it is very important to have a multidisciplinary follow-up before and after breast removal surgery.

breast reconstruction

In addition to constant psychological monitoring, breast reconstruction is a great alternative to regain post-mastectomy self-esteem. The surgery can be done together with the removal of the breasts or later, with the placement of silicone prostheses, use of expanders or transfer of tissues from other parts of the body to the breasts. This procedure does not include nipple and areola reconstruction.

It is important to point out that there is a Law No. 9,797of May 6, 1999, which guarantees the right to perform this reconstructive surgery free of charge, through the Unified Health System (SUS). Despite this, when comparing the number of mastectomies with the number of reconstructive surgeries performed by SUS, the difference is disturbing.

According to the Brazilian Society of Mastology, of the 110,000 Brazilian women who had their breasts removed in the last decade by the public system, only 25,000 underwent a reconstruction. In other words, access to the procedure is not proportional and ends up further affecting the mental health of this population.

However, in addition to breast reconstruction, there are other techniques that can help restore the self-esteem of patients who are unable, unable or unwilling to undergo the procedure. Among them are tattoos that cover the scar or even bras fitted with built-in prostheses. The important thing, at the end of the day, is to ensure that breast cancer and mastectomy do not interfere with a woman’s quality of life and well-being.

Content for educational purposes only. Consult a Doctor.

The translator user relied on the following source:

Minha Vida Website – REF99827

Disclaimer – (English version>) This content has been prepared based on information from research, additional publications, or the translation/verification work of a volunteer editor of this web council. This is a non-profit service. It is strongly recommended that all details and information published be carefully verified. We never allow medication recommendations, medication package inserts or any medication guidance. We never allow partisan politics as information.

Isenção de responsabilidade – (versão em português): Este conteúdo foi preparado com base em informações de pesquisas, publicações adicionais ou no trabalho de tradução/verificação de um editor voluntário deste conselho web. Este é um serviço sem fins lucrativos. É altamente recomendável que todos os detalhes e informações publicadas sejam verificadas cuidadosamente. Nunca permitimos recomendações de medicamentos, bulas ou qualquer orientação sobre medicamentos. Nunca permitimos a política partidária como base para checagem. Para mais informações, leia nossos termos.

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