Breast Cancer

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After Treatment TOPICS

Body image after breast cancer treatment

Along with having to cope with the emotional stress that cancer and its treatment can cause, many women with breast cancer also find themselves dealing with changes in their appearance as a result of their treatment.

Some changes may be short term, such as hair loss. But even short-term changes can have a profound effect on how a woman feels about herself. A number of options are available to help women cope with hair loss, including wigs, hats, scarves, and other accessories. Alternatively, some women may choose to use their baldness as a way to identify themselves as breast cancer survivors.

Other changes are more permanent, like the loss of part or all of a breast (or breasts) after surgery. Some women may choose reconstructive surgery to address this, while others may opt for a breast form.

Regardless of the changes you may experience, it's important to know that there is advice and support out there to help you cope with them. Speaking with your doctor or other members of your health care team is often a good starting point. There are also many support groups available, such as the American Cancer Society's Reach To Recovery program. Call 1-800-227-2345 or visit our website to learn more about programs in your area.

Breast forms and bras vs. breast reconstruction

After a mastectomy, you may consider having the breast mound rebuilt or reconstructed. This is usually something that is discussed before surgery to treat the cancer. Decisions about the type of reconstruction and when it will be done depend on each woman's medical situation and personal preferences. There are several types of reconstructive surgery available. Some use saline (saltwater) or silicone implants, while others use tissues from other parts of your body. You may also consider some type of reconstruction if you had breast-conserving surgery. Sometimes tissue from the other breast is removed so that the breasts look more symmetrical (even).

For a discussion of the different breast reconstruction options, see Breast Reconstruction After Mastectomy.

A breast form is a prosthesis (artificial body part) worn either inside a bra or attached to the body to simulate the appearance and feel of a natural breast. For women who have had a mastectomy, breast forms can be an important alternative to breast reconstruction. Some women might not want further surgery, knowing that breast reconstruction can sometimes require several procedures to complete.

If you are planning on using a breast form, your doctor will tell you when you have healed enough to be fitted for a permanent breast form or prosthesis. Most of these forms are made from materials that mimic the movement, feel, and weight of natural tissue. A properly weighted form provides the balance your body needs for correct posture and anchors your bra, keeping it from riding up.

At first, these forms may feel too heavy, but in time they will feel natural. Prices vary considerably. High price doesn't necessarily mean that the product is the best for you. Take time to shop for a good fit, comfort, and an attractive, natural appearance in the bra and under clothing. Your clothes should fit the way they did before surgery.

The right bra for you may very well be the one you have always worn. It may or may not need adjustments. If there is tenderness during healing, a bra extender can help by increasing the circumference of the bra so that it does not bind the chest too tightly. Heavy-breasted women can relieve pressure on shoulder straps by slipping a bra shoulder pad under one or both straps.

If you decide to wear your breast form in a pocket in your bra, you can have your regular bra adapted. There are also special mastectomy bras with the pockets already sewn in. If the breast form causes any kind of skin irritation, use a bra with a pocket. If your bra has underwires, you may be able to wear it, but be sure to clear this with your doctor.

You might want to wear your prosthesis under nightgowns but would like something more comfortable than a regular bra. Most department stores carry a soft bra, sometimes called a leisure or night bra.

Insurance coverage of breast prostheses can vary. Be sure to read your insurance policy to see what is covered and how you must submit claims. Also, ask your doctor to write prescriptions for your prosthesis and for any special mastectomy bras. When purchasing bras or breast forms, mark the bills and any checks you write "surgical." Medicare and Medicaid can be used to pay for some of these expenses if you are eligible. The cost of breast forms and bras with pockets may be tax deductible, as may the cost if you have a bra altered. Keep careful records of all related expenses.

Some insurance companies will not cover both a breast prosthesis and reconstructive surgery. That can mean that if you submit a claim for a prosthesis or bra to your insurance company, in some cases the company will not cover reconstruction, should you choose this procedure in the future. Make sure you get all the facts before submitting any insurance claims.

If you have questions, call your local ACS Reach To Recovery volunteer. She will give you suggestions, additional reading material, and advice. Remember that she's been there and will probably understand.

Last Medical Review: 09/25/2014
Last Revised: 02/22/2016