Medical Oncologist
Treatment options
Double mastectomy: when both breasts are removed
A double mastectomy removes both breasts, usually in one operation. It may be advised for cancer in both breasts or a high inherited risk, and some women choose it for peace of mind. This page explains who benefits most, what recovery involves, the honest limits of the surgery, and how to reach a decision.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is a double mastectomy, and when are both breasts removed?
- The main reasons for removing both breasts
- How the benefit usually differs
- The vocabulary, in plain language
- Honest realities about double mastectomy
- What recovery from surgery on both sides involves
- Steps that help you decide with confidence
- What people assume about double mastectomy
- Common questions about double mastectomy
The short answer
What is a double mastectomy, and when are both breasts removed?
A double mastectomy, also called a bilateral mastectomy, removes both breasts, usually in a single operation. It is advised in a few different situations. The first is when there is cancer in both breasts at the same time, which is uncommon but does happen. The second is for women with a high inherited risk, such as a harmful change in the BRCA or certain other genes, who have cancer in one breast and choose to remove the healthy breast as well to lower the chance of a new cancer there. The third is risk-reducing surgery for women who carry a high-risk gene change but have not had cancer. Some women without a high inherited risk also ask to remove the other breast, often out of worry about future cancer or a wish for symmetry. For these women, research shows that removing the healthy breast does not generally help them live longer, because the main risk to health usually comes from the cancer already diagnosed. The operation takes longer than a single mastectomy, recovery can be harder because both arms and both sides of the chest are sore, and the risk of wound problems is somewhat higher. Reconstruction of both breasts can be done at the same time or later, or you can choose to stay flat. It is a big decision that deserves time, genetic information where relevant and honest discussion with your team.
Cancer in both breasts
Removing both breasts may be the most direct way to treat cancers on each side.
High inherited risk
Women with certain gene changes may choose it to lower the chance of a new cancer.
Personal preference
For women at average risk, it usually does not improve survival, so weigh it carefully.
This page gives general information only. Genetic counselling and your surgeon can help you decide.Why both sides
The main reasons for removing both breasts
The benefit depends a great deal on which of these groups you belong to.
Cancer on both sides
When both breasts contain cancer and neither is suitable for breast-conserving surgery, removing both treats each cancer directly.
High-risk gene change with cancer
Women with a BRCA or similar gene change have a raised chance of a new cancer in the other breast. Removing it lowers that risk substantially.
Genetic testing results guide this decision.Risk-reducing surgery without cancer
Healthy carriers of a high-risk gene may choose to remove both breasts, often alongside regular screening as an alternative option.
Personal choice at average risk
Some women choose it for peace of mind or symmetry, especially if they plan reconstruction or want a flat chest.
Worth discussing first
- Your actual risk in the other breast
- Extra recovery and complication risk
- Loss of sensation on both sides
Not sure whether this applies to you?
Ask an oncologistWho benefits
How the benefit usually differs
Your situation
Likely benefit of removing both breasts
Cancer confirmed in both breasts
Treats both cancers; often the practical choice
High-risk gene change and cancer on one side
Greatly lowers the chance of a new cancer in the other breast
Healthy high-risk gene carrier
Lowers future breast cancer risk substantially
Strong family history, no gene change found
Benefit is smaller and varies; discuss with a genetics team
Average risk, cancer on one side
Usually no survival gain; mainly peace of mind or symmetry
Words you may hear
The vocabulary, in plain language
- Bilateral mastectomy
- The medical term for removing both breasts.
- Contralateral breast
- The breast on the opposite side to the cancer.
- Risk-reducing mastectomy
- Removing healthy breast tissue to lower the chance of future cancer.
- BRCA genes
- Genes that, when changed, greatly raise breast and ovarian cancer risk.
- Genetic counselling
- A session explaining inherited risk, testing and what results mean.
- Synchronous cancers
- Cancers found in both breasts at about the same time.
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Being straight with you
Honest realities about double mastectomy
Removing both breasts can bring relief, but it is not the right answer for everyone.
Risk is lowered, not removed
A small amount of breast tissue can remain on the chest wall, so a very small risk of new cancer stays even after removal.
It does not treat spread elsewhere
The biggest risk after breast cancer is usually the original cancer returning elsewhere, which removing the other breast does not change.
Both sides lose sensation
Numbness on both sides of the chest is usually permanent to some degree and can affect intimacy.
What this page cannot tell you
It cannot estimate your personal risk in the other breast. Genetic testing and your oncologist can.
After surgery
What recovery from surgery on both sides involves
Recovery follows the same pattern as a single mastectomy, but it usually feels harder in the early weeks.
Both arms are sore
Pushing up from bed, lifting a kettle or reaching up can be difficult for a while. Arrange practical help for the first couple of weeks.
More drains
You may have a drain on each side, sometimes more with reconstruction. A lanyard or pouch keeps them tidy.
Sleeping
Sleeping on your back propped with pillows is usually most comfortable at first.
Getting moving
Arm exercises matter on both sides to prevent stiffness. A physiotherapist can guide your routine.
Making the decision
Steps that help you decide with confidence
There is usually time to think this through, even when surgery is planned soon.
Get genetic information if it applies
Ask whether you meet the criteria for genetic testing. A result can change the balance of benefit.
Separate the two decisions
Treating the cancer now and removing the healthy breast are different choices. The second can be made later if you need more time.
Ask about reconstruction or flat closure
Knowing what the chest will look like helps you weigh the options.
Talk to women who chose each path
Support groups can share lived experience alongside medical facts.
Commonly believed
What people assume about double mastectomy
Removing both breasts always means living longer.
For women at average risk, it usually does not improve survival.
After double mastectomy, breast cancer can never occur again.
The risk is much lower but not zero, and the first cancer can still return.
You must decide about the other breast before the first surgery.
Risk-reducing surgery can often be done later.
Only reconstruction can give symmetry.
A flat chest on both sides also gives a balanced look.
Questions we are asked
Common questions about double mastectomy
Should I remove my healthy breast too?
It depends on your risk. For women with a high-risk gene change, removing the other breast can substantially lower the chance of a new cancer. For women at average risk, the benefit is usually small. A genetic assessment and a frank talk with your oncologist help clarify it.
How much longer is the operation?
Removing both breasts usually takes longer than one side, and reconstruction on both sides adds more time. Some hospitals have two surgeons working together to shorten it. Your team can estimate the time for your planned operation.
Is the complication risk higher?
Somewhat, because there are two wounds. Problems such as infection, fluid collection, bleeding and slow skin healing can occur on either side. The overall risk is still manageable for most healthy women, and your team will explain how they lower it.
Are lymph nodes removed on both sides?
Usually only on the side with cancer. A healthy breast removed to lower risk does not normally need node surgery. If there is cancer in both breasts, node surgery may be needed on each side depending on the findings.
Can I have reconstruction on both sides?
Yes. Both breasts can be rebuilt with implants or your own tissue, at the same time or later. Symmetry is often easier to achieve when both sides are reconstructed together. Some women choose a flat closure on both sides instead.
Will I still need mammograms?
Routine mammograms are usually not needed after both breasts are removed. You will still have regular check-ups and examinations of the chest wall. Report any new lump, skin change or pain that does not settle.
Does double mastectomy mean I avoid radiotherapy or chemotherapy?
No. Further treatment depends on the cancer's size, type and node involvement, not on how many breasts are removed. Radiotherapy, chemotherapy, hormone therapy or targeted treatment may still be recommended.
How do women feel afterwards?
Many feel relief and less worry. Some experience grief, body image concerns or regret, particularly if the decision was rushed. Taking time, getting information and using counselling support help women feel more at peace with their choice.
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Sources
- National Cancer Institute — Surgery to reduce the risk of breast cancer
- American Cancer Society — Mastectomy
- Cancer Research UK — Surgery to remove your breast (mastectomy)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.