Cancer in One Breast Doesn’t Mean Both Breasts Need Removed

Breast cancer is often treated with a mastectomy — removal of the breast. But cancer in one breast doesn’t mean you need to lose the other.

If you are diagnosed with cancer in one breast, your doctor will discuss treatment options, which depend largely on the stage, type, and size of the malignancy. If the tumor is small and at an early stage, you may be able to have a lumpectomy and radiation, or you may be advised to have the cancerous breast removed, a procedure called a unilateral mastectomy.

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What is a mastectomy? There are several kinds of this surgery, according to the American Cancer Society. All mastectomies involve removing the breast tissue and often the nipple and areola, as well. In modified radical mastectomies, lymph glands are also taken out surgically. Very rarely, due to large tumors growing into the pectoral muscles, radical mastectomies are performed to remove chest wall muscles under the breast, along with breast tissue and lymph glands.

Even a simple unilateral mastectomy is major surgery that can result in post-operative pain and down time for healing. Some women who need to have only one breast removed due to cancer prefer to have their other, healthy breast taken off, too.

With both breasts gone, they believe they will prevent breast cancer and another mastectomy in the future. But research shows having a healthy breast removed is not going to affect their future health outcomes in most cases.

There are some specific, rare exceptions,  primarily having a strong genetic risk for breast cancer. For example, double mastectomy of two healthy breasts makes sense for women who test positive for a BRCA1 or BRCA2 gene mutation, which greatly increases the risk of both breast and ovarian cancer.  

In those cases cases, removing both breasts prophylactically, before any cancer develops, can reduce the risk of breast cancer by about 90 percent, according to the National Cancer Institute. In women with a very strong history of breast cancer, which indicates a genetic risk, removing both breasts has also been shown to lower the risk of developing breast cancer.

For other women with cancer in one breast, especially if they receive chemotherapy or hormone therapy as part of their cancer treatment after surgery, there is not a good medical reason to have a healthy breast removed.

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