Double-Sided Breast Reconstruction Cases Increasing

In recognition of Breast Cancer Reconstruction Day, a plastic surgeon reflects on the trends he sees at the hospital.

Breast Reconstruction Awareness (BRA) Day is Wednesday, and the options for breast reconstruction following mastectomy has changed significantly over the last 30 years.

Recently, I’ve noticed in my practice that the number of two-sided breast reconstruction surgeries has increased. It seems to me that more women are opting for a bilateral mastectomy even if the cancer has not spread to both breasts. Although mastectomy is not considered a high risk surgical procedure, there are obvious aesthetic, functional, and psychological concerns, as well as potential long-term effects (like chronic pain) that could affect a person’s overall quality of life. Despite this, a recent study showed that 98 percent of women would opt to undergo this procedure to decrease their risk of cancer. Similarly, 95 percent of women felt that it gave them peace of mind, and 94 percent claimed that they believed it would prolong their life.

The considerable technological advancements made in cancer screening including genetic testing has enabled detection of cancer at an earlier stage than ever before, and this has undoubtedly influenced the emerging trend. Furthermore, with a multitude of options available for subsequent breast reconstruction, the potential detrimental effects on body image and sexuality have been, to a degree, alleviated.

Are there benefits of having a bilateral (two-sided) reconstruction versus a one-sided reconstruction? There is not always a straightforward answer. What I tell my patients is “treatment before reconstruction.” What is evident now is that there’s a change in patient attitudes and towards the surgical options for breast cancer. This is coupled with the public’s increased exposure to important information regarding the potential risks. This may have increased a woman’s desire to undergo bilateral mastectomies to maximize cancer treatment benefit, cancer prevention, and enhanced aesthetic symmetry of their breasts.