Double Mastectomy Recovery: Tips and What to Expect

By Dr. Garvit Chitkara in Nanavati Max Institute of Cancer Care

Apr 24 , 2023 | 6 min read


A double mastectomy is a surgery to remove both breasts. It is also known as a bilateral mastectomy and is performed by a breast cancer doctor to remove cancer. It is also performed on women at high risk of breast cancer. This is a major surgery that requires a hospital stay. The recovery time may be a few weeks.

What is a Double Mastectomy?

A double mastectomy is a surgery that involves the removal of both breasts. It is used to treat breast cancer. It reduces the risk for women who are at high risk of suffering from breast cancer.

A double mastectomy is recommended for patients with late-stage cancer in both breasts and those who carry one of the genes linked to breast cancer, thus increasing their chances of getting the disease. Double mastectomy recovery tips are crucial for a complete recovery.

Why have a Double Mastectomy?

A breast cancer doctor recommends a double mastectomy if the patient has late-stage breast cancer in both breasts or if there is no option for a lumpectomy.

Patients with early-stage cancer in one breast and at high risk of getting cancer in the second breast undergo a double mastectomy.

Patients with a family history of breast cancer or who carry the genes BRCA1 and BRCA2 linked to the disease can also have a double mastectomy.

Furthermore, some patients are not at risk of getting cancer in the second breast but want to avoid the possibility. The procedure for removing the second healthy breast is known as contralateral prophylactic mastectomy or CPM.

What are The Different Types of Double Mastectomy Surgeries?

There are four types of double mastectomy surgeries.

  • Skin-sparing or nipple-sparing mastectomy involves the removal of the breast tissue. The surgeon preserves the better part of the skin and, in some cases, the nipple and the areola. This is conducted if the patient has very early-stage cancer, which is not located near the nipple or has not affected the skin.
  • Simple mastectomy involves removing the entire breast, the overlying skin, the nipple, and the areola. At times, the surgeon may also remove the sentinel lymph nodes.
  • Modified radical mastectomy involves the removal of the breast, the nipple, the areola, and most of the overlying skin. Apart from these, the lining of the chest muscles, a part of the muscle, and the axillary lymph nodes are also removed. Axillary lymph nodes are located under the armpits, near the breast, making them the first place where cancer spreads if it moves beyond the breast tissue. If cancer has spread to the axillary lymph nodes, the surgeon removes them during this procedure.
  • Radical mastectomy involves the removal of the entire breast, the nipple, the areola, the chest muscles, and the axillary lymph nodes. This rare procedure is conducted only in case of larger tumors growing in the pectoral muscles. The pectoral muscles connect the front walls of the chest with the bones of the shoulders and upper arms.

What to Expect During and After Double Mastectomy Surgery?

The doctor will remove the skin, nipple, and areola during the surgery. This includes the lymph nodes under the arm. The doctor may also remove the pectoral muscles. Besides this, the doctor will remove the breast tissue and insert a tube or two to help the fluid to drain out.

The doctor may perform breast reconstruction at the same time as a mastectomy. Once this procedure is complete, the area will be closed with stitches. The patient must stay in the hospital for a couple of nights under observation.

Recovering from a Mastectomy

Recovering from a mastectomy depends upon the specifics of the surgery. The breast cancer doctor prescribes certain instructions about care after surgery to be followed at home. These are:

  • Dressing and caring for the surgery site
  • Caring for the drain attached to let out the fluid
  • Checking for infection at the surgery site
  • Moving the arm and exercising it to reduce the stiffness
  • How to bathe after surgery
  • Wearing a bra carefully after surgery
  • Consuming pain medications and antibiotics at the right time
  • Dealing with the numbness in the arm and breast
  • Understanding and dealing with body image issues
  • When to visit the doctor for a follow-up

Side Effects of a Double Mastectomy

The side effects of a double mastectomy are based on the complexity of the surgery. Common side effects include:

  • Fatigue for a few days after the surgery.
  • Pain in the surgical area and soreness in the chest, underarms, and shoulder.
  • Numbness across the chest, which could get better, or it may be permanent.
  • Swelling in the surgical area, arms, hands, fingers, and back due to blood or fluid build-up in the wound.
  • Limited movements of the arms and shoulders.

Treatment After a Double Mastectomy

To prevent cancer from recurring, some patients are given additional treatment. This helps kill the microscopic cancer cells to prevent their spread. This treatment is called adjuvant therapy, for example:

  • Chemotherapy: This is the first adjuvant therapy after surgery.
  • Hormone therapy: This treatment blocks estrogen and prevents the further growth of cancer cells.
  • Radiation: This treatment is prescribed to reduce the chances of cancer recurrence.

Frequently Asked Questions

1. How long does it take to recover from a double mastectomy

Recovery varies from person to person. But, it typically takes four to six weeks to recover from a double mastectomy. If the patient undergoes breast reconstruction surgery at the same time as the mastectomy, it may take six to eight weeks to recover.

2. How soon can you get back to work after a double mastectomy?

After a double mastectomy, a patient takes four to six weeks to recover, after which it is important to follow the double mastectomy recovery tips to regain stamina before patients get back to work. In the case of other treatments or breast reconstruction, they may take longer, as the recovery time is more after these procedures.

3. Do you lose weight after a double mastectomy?

A breast cancer diagnosis affects a patient’s life, and the treatment, medications, and stress can lead to weight gain or loss. Patients usually gain weight after a double mastectomy. However, some patients lose weight. Breast cancer treatments, such as hormonal therapy, and medicines such as pain medication, anticonvulsants, steroids, and bone-strengthening drugs can cause fluctuations in weight.

4. How painful is a mastectomy recovery?

The intensity of pain after a mastectomy varies between patients. They may experience chronic pain in the chest wall, armpit, and arm due to nerve damage. Patients may also experience shooting or prickling pain, numbness, burning sensation, and itching around the area of surgery. Patients treated with radiation therapy or those who undergo axillary lymph node dissection may commonly experience chronic pain.

5. How long does fatigue last after a mastectomy?

A double mastectomy is a major surgery, and the patient may experience fatigue for days or weeks afterward. Patients also experience depression, fear, anxiety, and concerns about their body image, which could add to exhaustion. This could last for two weeks or more. Therefore, it is important to seek help and support from family and friends.

6. Can you still get cancer after a double mastectomy?

If breast cancer cells remain even after a double mastectomy, or adjuvant therapy, they can grow and multiply over a period of time, which can cause cancer to recur. This may happen after months or years and spread to other organs or bones.

7. Who might get a mastectomy?

Women who have breast cancer or are at risk of developing it may get a mastectomy to remove either one or both breasts.