Constance M. Niclas, MHA, CMF, CF-M
Reprinted by permission of COPING® Magazine
Last Modified: April 27, 2009
Women with breast cancer face several cosmetic changes that may affect their body image and quality of life, including the loss of one or both breasts. In order to feel better about themselves and their bodies, some women may choose to be fitted with a breast prosthesis. Breast prostheses are breast forms that are put inside a bra to make your breasts look natural and balanced.
All women are wonderfully different; therefore, the breast form you choose must satisfy your specific needs. When it comes to breast forms and intimate apparel, a myriad of choices are available. The goal is to find a prosthesis in which you feel comfortable, natural, and beautiful inside and out.
Finding the Right Fit
It is important to select a well-fitting bra to provide support for daily activities. So many women wear the wrong size bra because they have never been fitted properly. The finished product of a bra should be one of comfort, function, fit, and fashion.
Busts vary anatomically with respect to horizontal protrusion, vertical droop, nipple position, and bust shape. Breast prostheses can be worn in either a mastectomy bra or a regular fashion bra. The letters AA, A, B, C, D, and DD are used as cup sizes to denote bust sizes of ready-to-wear bras. A numerical value is used to denote the band size of the bra. A numerical sizing system is used in the fitting of the prosthesis as well. A mastectomy fitter can help you select the bra that is right for you.
The removal or partial removal of the breast and/or the axillary lymph nodes is a common surgery for women with breast cancer. Your skin can be sensitive after surgery and radiation, and the slightest pressure on the chest wall may cause irritation. You may receive a lightweight foam prosthesis with a front closure surgical bra to accommodate the chest wall and begin to restore the natural shape and contour of your breast. There are also camisole styles available to accommodate the prosthesis.
A radical mastectomy usually requires a prosthesis that extends with a longer tail that can be rotated to fit into the chest wall of the axillary area. Many shapes and styles are available – asymmetrical or symmetrical – for maximum comfort and fit. If you have tissue expansion reconstruction or breast implants, you may require an enhancement prosthesis to restore the breast shape and contour.
Nipple prosthetics are also available, as many women who undergo breast reconstruction may not opt for nipple reconstruction right away, or even at all. When shopping for this product, it is best to wear your favorite sweater or bra when trying on the prosthetic.
Will My Insurance Cover It?
Under the Women’s Health and Cancer Rights Act of 1998, if your group health plan covers mastectomies, your plan must provide certain benefits if you choose reconstructive surgery. For more information, contact the Department of Health and Human Services at (877) 696-6775.
In addition, Medicare is also legally required in each state to provide you with surgical bras (code L8000) every year. Every other year, a traditional breast form (code L8030) can be obtained. You should also be fitted for a swimming or leisure form (code L8020); both can assist you in hydrotherapy or exercise activities. Check your state for the reimbursement amount, as insurance regulations change.
Caring for Your Prosthesis
Wash your bra every time you wear it, and rinse it well. If you hand wash your bra, be aware that residual detergents can be lurking in the elastic band, which could lead to skin irritation if not removed. Also, some body washes contain chemicals that can become irritants to your skin when not washed off properly.
Store your prosthesis in the suggested manufacturer packaging after washing and drying it. Use caution when handling your prosthesis, as sharp objects such as pins and rings can rip the silicone. Do not buy a product without a warranty from the manufacturer; it should be good for two years from the date of purchase.
Editor’s Note: Constance Niclas is supervisor of the Ellen H. Lazar Shoppe on Fifth at the John Theurer Cancer Center at Hackensack University Medical Center in Hackensack, NJ.
Action! Prosthetics are available for purchase from a variety of places, including online, direct marketing catalogues, retail shops, and hospital oncology boutiques.
Reprinted by permission of COPING® Magazine, www.copingmag.com