The number of women choosing to have a breast reconstruction after a mastectomy has been steadily increasing. According to a 2013 study, reconstruction rates rose from 46% of women having mastectomies in 1998 to 63% in 2007. However, there are other options if you are concerned about having another surgery, don’t have time to recover from the one or more procedures involved, have other health issues, or just decide reconstruction is not for you.
For Andrea Zinn, who was diagnosed with stage IIIB breast cancer in her right breast at age 32, the answer was wearing a breast prosthesis or artificial breast form.
Breast forms are custom-designed for most women. They can be made from several different types of materials, such as silicone gel, foam, or fiberfill, to create something that has a similar weight and feel to a natural breast. Some breast forms adhere directly to the chest area, while others fit into special bra pockets that help hold the prosthesis in place. Breast forms can also be made with an artificial nipple or a special shape, depending on a woman's preferences.
Q: Why did you decide to wear a breast form/prosthesis rather than have a reconstruction?
Andrea: After weighing the options with my breast surgeon and medical oncologist, I decided to only have a single mastectomy. Since I am BRCA1- and BRCA2-negative, a double mastectomy would not have improved my overall survival.
I met with a plastic surgeon for a consultation on reconstruction options. I’m not a great candidate for a breast implant, and I am not really interested in having the DIEP flap procedure that was recommended to me. It’s a big surgery, and I wasn’t willing to take on the risks.
My mother is an 11-year breast cancer survivor. She also had a single mastectomy and wears a prosthesis. I remember going to a fitting with her after her surgery and seeing how comfortable she was with her prosthetic. It hasn’t limited her in any way. It helped me decide not to pursue additional surgery.
Q: What was being fitted for your prosthesis like?
Andrea: The process reminded me of being fitted for a bra. I went to a local lingerie shop that was a covered provider on my insurance plan. I met with a professional fitter who took one look at me and brought out the perfect prosthetic on the first try! She was then able to recommend a good bra that would help support my large, healthy breast while fitting the prosthetic comfortably.
The staff was very caring and professional. The shop directly billed my insurance company so I just had to pay my copay. Later, I brought a non-mastectomy bra that I liked, and the seamstress sewed a pocket into the bra so I could wear it with my prosthetic.
Q: How did having a mastectomy and then wearing a prosthesis change the way you felt about your body?
Andrea: I’ve always had a love/hate relationship with my breasts. I developed early, and my breasts have always been large and heavy. When it came time for my mastectomy, I wasn’t too upset to see my breast go!
Most days, I forget that my prosthetic isn’t real. The form fits so well against my chest wall that it feels like part of me. I’ve had to be cautious about not wearing a low neckline, but my surgeon did a tremendous job of giving me the illusion of cleavage with the type of incision she did. Still, I’m sad sometimes when I look at a gorgeous dress or blouse with a plunging neckline because I know I can’t wear something like that anymore.
I’ve never felt like less of a woman because I am missing a breast. It does make things like wearing pretty bras or lingerie more difficult, and sometimes choices are limited. However, there are growing options for mastectomy bras, lingerie, swimwear, and workout gear. So, I don’t feel like by choosing to wear a prosthetic I’ve missed out on wearing pretty bras or swimsuits.
Q: Do you have any tips for other women who might be trying to decide if a breast prosthesis is right for them?
Andrea: You can always meet with a professional fitter to talk about the fitting process and look at some samples of breast forms and mastectomy bras. There are a lot of options out there, and looking at some of the choices may help you decide if wearing a prosthetic is something you would like to do. It’s important to choose a professional fitter who has had specific training in how to fit breast prosthetics.
You can also:
- Talk with other survivors who wear a prosthetic, or visit some online message boards if you don’t know anyone who wears a form.
- Weigh the pros and cons of reconstructive surgery versus a prosthetic. If you can, get a few consults from different plastic surgeons to find out what kind of surgical options might be right for you.
Q: Is there anything else you think women with breast cancer should know?
Andrea Zinn was diagnosed with breast cancer in October 2012. She is currently a volunteer state leader and a Face 2 Face Network coordinator for the Young Survival Coalition.