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Fighting Breast Cancer: Is Double Mastectomy Right For You?



Breast cancer will strike about 300,000 women in 2013, according to the key statistics provided by Of these, nearly 233,000 will be the invasive form of breast cancer, and the remaining will be the in-situ or CIS form.

This is not technically cancer; it is a precancerous change in cells within a duct or a lobule of the breast, is confined to a localized area within the breast, and makes you susceptible to developing cancer. While these precancerous cells or lesions may not develop into full-blown cancer, it is difficult for physicians to predict their progression.

For the large group of women diagnosed with invasive carcinoma of the breast, choices of treatment depend upon the stage of the disease. One or both breasts can be affected. Once a mastectomy is recommended, some women consider the option of bilateral mastectomy — removal of both breasts — even if only one breast has malignant cells.

Removal of the healthy breast in a bilateral mastectomy is known as CPM or contralateral prophylactic mastectomy. In increasing numbers, women are opting for double mastectomy for a variety of reasons. Multiple factors need to be considered before taking this major decision.

Genetic Risks

If you have cancer in one breast, and you have first-degree relatives who have had it, you are at an increased risk of cancer in the other breast. With a strong likelihood of this disease invading the healthy breast, you may consider the option of having it removed to cut the future risk of cancer and compromised quality of life. The presence of cancer in one breast combined with a presence of cancer in the family predisposes you to a very high level of the risk of developing cancer as you age.

A second scenario occurs when you do not have breast cancer, but you have a strong family history of it. Genetic testing can confirm the presence of gene mutations that are responsible for causing cancer of the breast. These are known as BRCA1 and BRCA2 genes. A genetic counselor can help with advice and testing.

Presence of Abnormal Breast Changes

Routine mammograms can detect early changes in the breasts. If precancerous changes are observed, such as those in the duct or lobules, your risk of developing cancer in both breasts is elevated. Whether or not you choose to opt for a prophylactic mastectomy should be a decision taken after consulting with a good medical team, and after taking into account your family history. It is also imperative to remember that not all cases of carcinoma-in-situ will progress to invasive carcinoma.

All women dread breast cancer. Regular mammograms and genetic testing of mutations, if necessary, upon evaluation of family history go a long way in combating mortality associated with cancer. Not all women affected by breast cancer need double mastectomies. Surgeries carry risks; benefits must outweigh the risks in any surgery. For some women, there are no options; for others, a double mastectomy may reduce the anxiety of developing this killer disease.

After breast cancer surgery, survivors have another decision to make. While breast removal offers them better chances of long-term survival, appearances matter as well. Women must decide on reconstructive surgery and/or breast augmentation to restore the original appearance of their breasts.

While prosthetic devices and special bras can offer the appearance of normal breast tissue, surgical breast reconstruction or augmentation often helps women feel more complete following a mastectomy. Neither the decision to opt for a mastectomy or the decision for follow-up surgery should be taken lightly. Both have long-lasting consequences and benefits for every woman.