When should a bilateral mastectomy be considered?

A bilateral mastectomy should be considered if there are multiple tumors or a large tumor present in one or both breasts. This surgical option may be recommended to reduce the risk of cancer spreading and to remove as much breast tissue as possible if there is significant concern about the extent of the disease. This is particularly relevant when the cancer is aggressive or multifocal, meaning there are several areas of cancer within the breast.

This approach is part of a proactive management strategy, especially in cases where a patient's breast cancer diagnosis suggests a higher risk of recurrence or metastasis. The decision to choose bilateral mastectomy often involves a discussion about the stage and characteristics of the tumors, patient age, and personal health factors. In contrast, other options such as after a lumpectomy, only when cancer is stage 0, or when there is no family history of breast cancer do not adequately reflect the clinical rationale for this extensive procedure.