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Breast cancer has many causes and is hereditary. So it’s not surprising that those who are at risk or diagnosed are eager to seek prevention and treatment methods. A double mastectomy is one of the most common treatments for this disease. Aside from Hollywood actresses like Angelina Jolie, 17% of women also had the same surgery after being diagnosed with early-stage breast cancer.
With more than 40,000 deaths in 2021, it is considered one of the top five deadliest cancers in the US. All genders are at risk of breast cancer, so it’s vital to know the available treatments for this disease to prevent it from getting worse and causing death. Find out what mastectomy and double or bilateral mastectomy are in this article.
What Is a Bilateral Mastectomy?
Medical practitioners use two primary surgeries to treat breast cancer or the condition caused by uncontrolled cell growth in a person’s breast. First is lumpectomy, where surgeons remove cancer cells and a small portion of healthy breast tissue. On the other hand, mastectomy is a medical procedure to remove the entire breast of a person and certain body parts surrounding the concerned area.
In this treatment, the type of surgery relies on the quantity of breast tissue to be extracted, the size of the tumor, and other factors. The six classes of mastectomy are:
- Simple or Total Mastectomy – is a surgical operation to remove the entire breast, which includes the nipple, areola, fascia, and skin.
- Radical Mastectomies – are where the entire breast, lymph nodes, and pectoral muscles underneath the breast are removed, but this surgery is rarely done today.
- Modified Radical Mastectomy – is the removal of a person’s breast and axillary lymph nodes where cancer cells usually spread first.
- Skin-Sparing Mastectomy – this is an operation in which the skin of the breast is the only part that is preserved.
- Nipple-Sparing Mastectomy – a surgical option for early-stage breast cancer patients where only the breast tissue will be removed, and both skin and nipple are kept in place.
- Double or Bilateral Mastectomy – removes a person’s left and right breast.
A double or bilateral mastectomy is a significant surgery performed for the cure and prevention of breast cancer. It’s also called DMX surgery, and doctors usually suggest it to women who are at high risk for the disease or those who test positive for a BRCA or other related breast cancer gene mutation. But surgery can also be performed in low-risk patients.
Bilateral mastectomy surgeries lessen the risk of breast cancer in women with BRCA 1 and 2 gene mutations by 95%. Meanwhile, it also reduces the risk of developing breast cancer in a person with a strong family record of the disease by up to 90%. In this procedure, both breasts are surgically removed simultaneously to remove cancer cells and prevent the development of new cancer in the same or the other breast.
What Is a Double Mastectomy?
As stated above, bilateral and double mastectomy have the same meaning and purpose. Although it is a popular trend, as many do it to prevent breast cancer, only people who have been screened and diagnosed by an oncologist can have the surgery. The oncologist will tell you if a double or bilateral mastectomy is necessary and explain its advantages and disadvantages over other surgeries and treatments for breast cancer.
Besides reducing the chances of developing new cancer, most early-stage breast cancer and people at lower risk will choose to undergo DMX surgery as a treatment to avoid necessary follow-up mammograms and breast MRIs. New breasts created with double mastectomy reconstructive surgery look better and more balanced. However, remember that this operation also has risks, so it is better to consult a doctor first before deciding what treatment to take.
How Long Is a Double Mastectomy Surgery?
While other mastectomy surgeries only take an hour to complete, radical mastectomies and double mastectomy surgeries are estimated to take two to three hours in the operating room. Preparation for this operation also takes a lot of time. Before going to the hospital, they will ask you to have someone help or drive for you and bring comfortable clothes. Doctors will also remind you to stop taking medicine and aspirin products ten days before surgery.
The night before the day of surgery, they will require you not to eat or drink anything after midnight or for about 8 to 12 hours. Before surgery, the doctor will remind you and the family about double mastectomy surgery and your medical history and then mark the incision site on your breast. Then, a nurse will put an IV or intravenous infusion into your hand or arm and give a relaxing medicine.
Once you’re in the operating room, the anesthesiologist will put you to sleep by giving you general anesthesia. Through the incision made, the surgeon will remove all breast tissue, skin, nipple, and areola. Axillary lymph nodes and a portion of the pectoral muscles under the breast are also removed depending on how extensive the cancer is. This operation will take longer if it is a double mastectomy reconstructive surgery or the operation to rebuild the breast.
A surgeon can use saline or silicone gel-filled breast implants that usually take three to four hours to perform. But if the tissue flaps procedure or using muscle, fat, or skin from another part of the patient’s body is used for double mastectomy reconstructive surgery, it will take six to eight hours. Before closing the wound with stitches, the surgeon must check for bleeding, insert a surgical tube to drain excess fluid, and cover the area with a clean bandage.
Double Mastectomy Recovery Time
After surgery, you can expect to wake up feeling pain in your upper body, such as the chest area, armpits, and shoulders. A nurse will also teach you exercises to relieve and prevent arm and shoulder stiffness and scar formation. They may also remind you not to exercise too much until the drains have been removed for a week or ten days.
Recovery from a double mastectomy depends on whether or not the patient had breast reconstruction. If you haven’t had breast reconstruction, it will only take you three to four weeks to heal and feel back to normal. But suppose you decide to have double mastectomy reconstructive surgery. In that case, the expected recovery time is six to eight weeks because your doctors need to monitor your new breasts before they send you home.
Before you leave, they will give you a temporary bra insert or prosthesis while you wait for the doctor’s advice on bra fitting for about six to eight weeks after your operation. If you drive, it depends on how you feel, and if it hurts, don’t force yourself, but most people are back to driving within three weeks after surgery. Meanwhile, healthcare professionals will likely give you a manual containing steps to care for yourself after surgery. The instructions listed are:
- Prescription pain relievers
- The proper methods of care, cleaning, and dressing of the surgical site
- How to easily recognize the warning signs of infection
- The Dos and Don’ts of showering and bathing
- Demonstrations of various arm exercises
- When to fully recover and use the arm again without much pain
- Daily life restrictions
How Long Does It Take to Recover From Double Mastectomy?
This operation may have a short hospital stay, but full recovery from a double mastectomy takes at least several months. In most cases, people can only return to work four to eight weeks after getting a mastectomy. But you don’t have to worry because your physician can make a medical certificate to give to your employer if you need it.
While the painless swelling goes away in weeks, if the lymph nodes are removed during surgery, the numbness remains but improves over time. Another thing to remember is that the scar under your bra from the double mastectomy will fade over the months as you heal it but will not completely disappear from your body. Full recovery from a double mastectomy can be long, but it gives you time to check yourself and ensure your stitches are okay, there are no signs of infection, attend follow-up check-ups, and don’t push yourself and have complications.
Tips for Full Recovery From Double Mastectomy
- Rest and relax your mind as much as possible.
- Follow your doctor’s orders.
- Use a sponge in the bath until the tubes come out of your body.
- Do regular arm exercises.
- Seek physical and emotional support from family, friends, and support groups.
- Participate in enjoyable and easy activities.
Side Effects of a Double Mastectomy
Common side effects of double mastectomy mentioned above include swelling, numbness, and pain in the chest or near the surgical area, arms, and shoulders. But the impact of this operation varies from one person to another. It will also depend on how complex the DMX surgery is. Here are the more common and uncommon side effects a person gets after surgery:
- Experiencing fatigue and difficulty falling asleep
- Swelling of the hands, fingers, or back that may be caused by blood or fluid accumulation
- Inability or limited movement of the arms and shoulders
- People who have their lymph nodes removed during surgery may experience swelling in the arms or lymphedema
- Experiencing symptoms of postmastectomy pain syndrome or PMPS, such as severe pain, tingling, burning, itching, and numbness in the upper body
- Skin rashes or itching caused by either an allergic reaction to bandages, medical tape, radiation therapy, or cancer recurrence
- People who have breast reconstruction may feel lost and sad as they look at their new look because they have lost something dear to them.
- Development of negative body image
Treatment after a Double Mastectomy
It’s crucial for you to know that while a double or bilateral mastectomy reduces the risk of breast cancer recurrence because all the breast tissue is removed, it doesn’t mean it won’t happen. There is a minimal chance that a small remnant of breast tissue or cancer cells has caused breast cancer in your breast. Furthermore, even if a mastectomy prevents recurrence in the breast area, recurrent breast cancer cells can travel to other body parts.
That is why additional treatment is needed for some patients to kill the remaining cancer cells in the body, such as:
- Chemotherapy or targeted therapy – Is a typical or first adjuvant treatment given to every cancer patient after mastectomy.
- Hormone Therapy – A proposed therapy to block or reduce estrogen levels to stop the growth of cancer cells, but this therapy is unsuitable for all types of breast cancer.
- Radiation – Is usually offered to patients before a double mastectomy but is also suitable as an additional treatment if the cancer cells are still in the body.
When breast cancer recurs, surgery is usually an option. Then, radiation will follow, but only if the area of concern has not received radiation treatment. Chemotherapy is a way to make cancer cells smaller before surgery.
A Double Mastectomy Treatment
Now that you know that a double mastectomy helps in the fight against breast cancer, what else should you do about it? First, insurance companies that cover mastectomy must also pay for double mastectomy reconstructive surgery and prosthesis. Second, women have different opinions after surgery; one may like it and feel safer, while others regret and feel bad about removing their breasts, especially young women or those with early-stage breast cancer.
As for the downsides, getting a bilateral mastectomy doesn’t mean you are cancer free. It is also a more complicated procedure than a lumpectomy, and complications such as infection can occur. Finally, breast implants don’t last forever.
All American Hospice Is Here for You
And there you have it! You now know more about double mastectomy. Recovery from a double mastectomy may take longer than other treatments, but its benefits show that it is well worth it to save yourself from breast cancer. Although you can use this article as a reference if you are considering this treatment, consultation and various tests are still recommended.
Medical professionals, family, and friends can provide mental, emotional, and physical support to breast cancer patients. However, it still takes a toll on everyone involved.
At All American Hospice, we ensure that patients get full rest, get prescriptions on time, assist them with any kind of help they need, make them feel better, and more. Our medical professionals are always ready to help you fight. Give us a call today and inquire about our available services and nursing care plan for cancer patients.
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