Women's Health

• By Barry Walker, Peter Cartwright
• Feb 01, 2001

For the past several decades, the phrase "post-mastectomy market" has been used to refer to the market segment that addressed prostethic needs for women who were diagnosed with breast cancer and subsequently underwent surgery. This phrase has become increasinly inaccurate as women undergo breast conserving surgeries or choose reconstruction after mastectomy.

Surgical Trends

According to the American Cancer Society, 180,000 women will receive a diagnosis of breast cancer this year. In years past, the treatment for virtually all of these women would have included a mastectomy. Today, as many as 60 percent will, at least initially, undergo a breast-conserving surgery such as a lumpectomy. This means that at initial diagnosis, as few as 72,000 women will undergo mastectomy, a substantial decrease from years past.

Increasingly, women who have had mastectomies are choosing breast reconstruction. Passage of the Women's Health and Cancer Rights Act of 1998 mandating insurance coverage of this procedure has had a tremendous impact on the number of women choosing this alternative. According to the Plastic Surgery Information Service, 29,607 women under went breast reconstruction. By 1999, that number had grown to 82,975. These figures include resonstruction performed at the time of mastectomy, as well as procdures performed at a later time.

The numbers referenced above would seem to indicate there are no women who will need a full-size prosthesis. This is not the case for several reasons. It is unclear how many of the women who have recently had reconstructed are women who waited until the Women's Helath and Cancer Rights Act was passed. There are a number of women who may have had an initial lumpectomy but a recurrence resulted in a mastectomy. Large numbers of women still need full-sized forms. There also are women who will need some sort of partial form and were are seeing a signficant change in product development.

Prosthetic Designs In Recent Past

Prior to the 1970s, radical mastectomy was the standard surgery for women diagnosed with breast cancer. In addition to removal of the breast, this surgery included removal of chest muscle under the breast, tissue around the breast and under the arms, and axillary lymph nodes. Until the 1960s, women usually created their own prostheses, which were made from materials such as socks, stockings or birdseed. When commercial prostheses were first developed, they were typically liquid-filled shells. These first designs were created to replace the missing tissue and often extended under the arm.

Silicone became the material of choice for prostheses during the 1980s since it closely mimics the weight and texture of breast tissue. By this time, modified and simple mastectomies had become standard surgeries for those diagnosed with breast cancer and manufacturers of prostheses updated their prosthetic designes to meet the needs of women undergoing these surgeries. Improved silicone formulations and shapes such as the triangular form meant prostheses looked and felt more like the tissue that had been replaced.

Designs for the Future

The increase in lumpectomies and reconstruction means manufacturers must create products to address this new set of needs in the market. Following a lumpectomy, a woman may have a pronounced difference between the right and left breast. A full-sized breast prosthesis is not an option for her. Manufacturers have created parital forms for use after lumpectomy. An innovative new from was recently introduced by Camp Healthcare. The Signature Shell is a partial form featuring a layer of conformable, postionable gel in the back that fills in where there is a tissue deficit.

Following reconstruction, many women will still have a noticeable difference between the right and left breast. This often comes as a surprise to women and the difference often becomes more pronounced over time because the natural breast usualy ages more than the reconstructed breast causing a sag on one side. partial forms also are a solution for these women. The Signature Shell could be helpful in this situation since a common complaint is the need for something to fill out the nipple area of the reconstructed breast; the conformable gel can be moved to that area.

New Market Strategies

The Signature Shell is one new product designed to address this change in the market and there are sure to be more. While manufacturers are working to create new products for this change in market, there also is work to be done by dealers. Marekting effost must be refocused to include these types of products. At Camp Healthcare, we are increasingly using the phrase "after breast surgery" instead of "post-mastectomy". You may want to consider doing the same.

When a woman has a mastectomy, she will seek out a prosthesis at your establishment. She knows to look under mastectomy or post-mastectomy in the phone book. On the other hand, a woman who has had a lumpectomy or reconstruction may not realize there are products out there to address her size asummetry. When you advertise, be certain to include these new products that address the changes in surgery today. It is important to let physicians, support groups, and other potential referral sources know you carry these products. Let them know how the post-mastectomy market is changing!

This article originally appeared in the February 2001 issue of HME Business.