What should you know about elective double mastectomy?

A bilateral mastectomy may treat cancer in one breast while reducing the chance of a new breast cancer in the other, particularly when inherited risk or other factors are substantial. It does not remove cancer from other parts of the body, and it may not remove the need for chemotherapy, radiotherapy, hormone treatment, or follow-up. Some people with Breast Cancer or Paget Disease of the Breast may instead be offered breast-conserving surgery, depending on tumour features and personal circumstances.

The operation can remove breast tissue and may include nipple or lymph-node surgery. Reconstruction can happen at the same time or later, or you may choose a flat closure or prosthesis. Each option has different recovery and appearance considerations.

Ask the breast team to explain why both sides are being considered, what tissue will be removed, and whether Lumpectomy is a suitable alternative. Discuss genetic counselling, imaging, lymph-node assessment, reconstruction, drains, pain relief, arm movement, work, and help at home. Tell the surgical team about medicines, smoking, diabetes, allergies, and previous operations. If chemotherapy before surgery is planned, clarify its timing and how it affects the operation.

Contact the surgical team for increasing redness, warmth, swelling, wound separation, worsening pain, fever, cloudy drain fluid, or a drain that suddenly stops while the area becomes tense. Seek urgent help for severe breathlessness, chest pain, fainting, or sudden one-sided arm swelling. Gentle movement should follow the team’s instructions; do not force the shoulder while wounds are healing.

Ask how surgery changes recurrence and new-cancer risk in your situation, whether lymph nodes will be removed, what reconstruction choices exist, and how pathology affects further treatment. Clarify drain care, scar expectations, sensation changes, arm exercises, lymphoedema risk, and the contact number for recovery concerns.