Getting Back to Life

Today, approximately three million women in the United States are living with breast cancer, according to the National Breast Cancer Coalition (NBCC), an organization dedicated to eradicating breast cancer through action and advocacy. Approximately two of these three million women have been diagnosed, and an estimated one million do not yet know they have it.

Excluding skin cancer, breast cancer is the most commonly diagnosed cancer in the world. Last year, more than 251,300 new cases were expected to be diagnosed in the United States. Breast cancer is the leading cause of cancer death for U.S. women between the ages of 20 and 59, and the leading cause of cancer deaths worldwide.

While older women are much more likely to develop breast cancer than younger women, the reality is that younger women still get the disease. In fact, according to the American Cancer Society, one in every 258 women between the ages of 30 and 40 will be diagnosed with breast cancer in the next 10 years.

Despite these statistics, breast cancer is treatable if diagnosed early, and many women are surviving for years with the disease. They are empowering themselves with knowledge about their treatment options, forming support networks, and returning to their normal routine as soon as possible after surgery. As they resume active daily lives -caring for their families, managing busy careers, participating in their communities, and enjoying leisure activities-women want to feel good about themselves and their physical appearance.

Breast conserving surgeries are estimated to account for more 75 percent to 80 percent of all breast cancer surgeries performed in the United States each year.

In the early 1900s, when the first mastectomy was performed, there were no breast prostheses available. Women either did without or made their own out of available materials. The results were not always flattering, nor could the homemade breast form compensate for the loss of a natural breast.

Wide Array of Products Available

Today, breast cancer survivors have a wide array of products available to them following any type of breast surgery, including mastectomy, lumpectomy or reconstruction. Normally made of silicone with a polyurethane film covering, breast prostheses, also known as breast forms, now offer women a very natural looking replacement for a surgically removed breast.

Breast form manufacturers today employ leading edge technology to enhance the designs and features of their products. Because no two women are alike, a wide range of products is needed to help women feel comfortable about themselves and their appearance. Women can choose from lightweight or standard silicone, soft or firm front, attachable or non-attachable, and standard or moldable back, among others. In addition to hundreds of styles and sizes, a broad selection of shapes, skin tones and colors can match every type of surgery, body type and lifestyle.

To accommodate breast forms, there are stylish, feminine and supportive post-mastectomy brassieres-a critical element of the fitting process. If the bra fits well, the breast form will look and feel more natural. Today's styles feature fashionable fabrics and soft inner pockets to securely hold breast forms in place.

With earlier diagnoses and more effective treatments, more women are returning to active lives after breast surgery than ever before. To meet the needs of women who enjoy the water, post-mastectomy swimwear is now more common. Collections of swimsuits featuring higher armholes and necklines, and swimwear that holds breast forms in place with strong mesh pockets are available for these active women.

Fitters Hold Key Role

Breast surgery patients can find bras, breast forms and swimwear at specialty boutiques, stores within hospitals, or even the lingerie section of major departments stores.

Women are assured of finding the breast forms and bras best suited to their individual needs and lifestyles by working with a certified mastectomy fitter. Fitters frequently develop trusted relationships with their customers, and often serve as counselors and support systems for women who need to know that someone is there for them.

"Being a good listener is the best communication skill there is," said Linda LeMaire, a fitter at Riverside Health Equipment in Kankakee, Ill. "I can use my professional knowledge to pick out the best products, but the bottom line is that each woman must be comfortable and pleased with the way she looks."

The Board for Orthotist and Prosthetist Certification (BOC) is an independent, not-for-profit agency that certifies orthotists, prosthetists, orthotic and mastectomy fitters and accredits their facilities.

Every BOC-Certified practitioner has a unique combination of technical knowledge, experience and skill that comes from years of providing patient services under the direct supervision of a certified practitioner.

Amoena®, and other breast product companies offer continuing education seminars with BOC credits to enhance the skills of fitters, and keep them updated about the latest breast surgery techniques, new manufacturing technologies and product line advancements. Part of the training involves hands-on fitting with live models, giving fitters the opportunity to measure bra sizes and check symmetry.

Jan Boerman, a fitter at Naturally Yours, a specialty boutique in Willow Brook, Ill., that assists women in hair and breast prosthetics, says it takes time and experience to learn how to apply educational tools in the fitting room.

"Training really happens in the fitting room with our clients," she said. "Every person we meet gives us a different educational experience. I bring in several models for them to try before we find the right one."

New Generation of Breast Forms

Over the past decade, sophisticated technology and state-of-the-art manufacturing techniques from Amoena® have given women a wide variety of choices and options when selecting bras and breast forms after their surgery.

By regularly involving health care professionals, retailers and breast surgery patients, Coloplast has explored ideas for new solutions through product development and market testing. Scientists and engineers continuously conduct research with raw materials and process technology, and study the interaction between adhesives and skin.

Today, Amoena breast forms are crafted using an advanced manufacturing processes and a unique silicone mixture-a combination that produces products with a remarkably natural look and feel.

This technology has helped create a new generation of both traditional and attachable breast forms that are not only more aesthetically pleasing, but also more functional for women with busy, active lives.

Over the past decade, traditional breast forms have become lighter weight, more anatomically shaped, and more comfortable to wear. More than 40,000 women have chosen Amoena's Prema®, a lightweight breast form with Shapes2U technology, which conforms to the unique shape of the chest wall and holds that shape until the form is removed.

The form is designed to meet the needs of newer surgeries that remove less tissue under the arm and near the sternum.

"Women are wild about Shapes2U," said Linda LeMaire. "I have fitted many of them, and women say it feels just like them. It is lighter than the heavy duty breast forms, yet still maintains balance."

Advances in attachable breast forms, first pioneered in 1992 by Amoena®, have created breast shapes with a specially formulated light as air silicone that adheres directly to the skin, and feels and moves much like a natural breast.

Tria® Contact® Light, introduced last year, married advanced adhesive technology with lightweight silicone to create the perfect combination of lightweight comfort and attachable confidence in one two-layer attachable breast form. Tiny pearls-raised areas that cover the back of the breast form and chest wall-create more direct contact between a larger area of the form and the chest wall. A specially formulated contact gel works with the "pearls" to create an unusually strong bond between the wearer and the breast form.

Breast Conserving Surgery Products

This year, breast surgery patients have an even wider array of choices in breast forms, specially designed to address changing breast surgery techniques. In January, Amoena® introduced a new global breast form product portfolio that offers the best selection ever available to women in North America.

The product line contains a wider variety of offerings for women who have had breast conserving surgery, which has become the treatment of choice for many women with early-stage breast cancer. Today, breast conserving surgeries are estimated to account for more 75 percent to 80 percent of all breast cancer surgeries performed in the United States each year, according to a Coloplast advisory panel of health care professionals.

Women are assured of finding the breast forms and bras best suited to their individual needs and lifestyles by working with a certified mastectomy fitter.

In October 2002, The New England Journal of Medicine published results of two pivotal Italian studies showing that there is no evidence that mastectomy has a significant 20-year survival advantage over breast conserving surgery. Lumpectomy and other breast conserving techniques not only preserve normal breast tissue, but prevent many complications associated with radical and simple mastectomies.

To meet the needs of patients who opt for breast conserving surgery, the new Amoena® product line contains a wider selection of offerings called Balance to replace missing tissue and fill out the bra for an even look. Two of these products are full silicone shells that can be placed over the breast to replace lost tissue and balance the figure, creating a smoother, more even profile.

The other two Balance products are partial silicone tops and bottoms that do not cover the nipple, and can be placed to compensate for the tissue deficiency. Research and development is continuing to improve the functionality of breast forms for women who have had breast conserving surgery, and create attachable partial silicone pieces.

The enhanced Amoena® global product line also contains:

The worldwide introduction of Tresia, an improved, lightweight triangle-shaped breast form developed from our experience in creating custom fitting breast forms. Tresia is the second product offering that utilizes Shapes2U technology. A new triangle shaped Tria® Swimform product that allows water to flow through for comfort An aesthetically pleasing matte finish and standardization of colors.

On the Horizon

In coming years, Amoena® will continue to listen to the needs of women after breast surgery, and employ state-of-the-art technology to develop innovative products that accommodate changing surgical techniques and meet the diverse needs of all women. For example, research and development is continuing for the development of attachable Balance parts, bras with partial silicone pieces, and a lymphedema bra.

"Breast forms have come a long way from being a nasty-looking piece of hard rubber," said Linda LeMaire. "In the future, women will continue to look for lighter weight forms that still give balance. They want attachables that will stay with them when they swim, front closure bras for all shapes and sizes, and expanded colors. Bottom line-they want that form to go anywhere they do and hold up in any situation."

With earlier diagnoses and more effective treatments, women have the greatest chance ever of returning to their normal routines after breast cancer. Working closely with retailers and fitters, companies can provide products to help women continue to lead full and active lives for decades to come.

This article originally appeared in the April 2003 issue of HME Business.

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