Michele Owens (right) with postmastectomy patient.

Women diagnosed with breast cancer have a growing understanding of their varied treatment options—radical mastectomies are making way for more breast-conserving surgeries and reconstruction to maintain a natural appearance. However, many women remain in the dark about such topics as how to create the appearance of a breast if they forego reconstruction, how to feel comfortable being intimate again, or how to find the resources that will address their concerns.

While the state of postmastectomy products is certainly not what it was decades ago—when women’s products were relegated to the back of HME stores, prosthetics fitters were men, and bras resembled harnesses—the industry still struggles to be recognized for its role in helping women heal.

“Breast cancer is not an easy thing to face, and most women are not aware of what postmastectomy products even are until they’ve been diagnosed. Many patients have never even seen prostheses,” says Helen Reese, manager of Prosthetic Laboratories’ Silhouette Shop, which has a location in Rochester, Minn, and satelite offices in Baxter and Mankato, Minn, and in LaCrosse and Eau Claire, Wis.

“While women will usually be sent to see a plastic surgeon about reconstruction before their surgery, they often don’t know what their other options are,” agrees Michele Owens, founder of Fittings by Michele in Pasadena, Md. “Many times, women are not told by their oncologist that partial breast forms are even available.”

Reese and Owens opened their businesses because they were dismayed by the status of women’s products within traditional HME companies. The same is true for Beth Davis and her mother Ann Ward, founders of Just Like You in Ruston and West Monroe, La.

“In the 1980s, breast prosthetics fittings were done in the shoe fitting room—but if you were a woman who needed a breast form, that is where you went,” Davis says. “Then in 1995 my mother worked in a boutique that carried only postmastectomy products. We had never heard of such a thing, but that is what made my mom decide that she wanted to open a special place just for women.”

In other cases, proprietors of postmastectomy product boutiques have first-hand experience with cancer. Being diagnosed with breast cancer led Bink Cook to open The Brighter Side in Solana Beach, Calif, and Jan Boerman founded Naturally Yours in Willowbrook, Ill, after seeing her husband go through the rigors of cancer treatment.

“There obviously was a need for mastectomy products as well as for all the hair alternatives, books, and gift items related to breast cancer,” says Cook, who opened her store in November 1994 and has been in the black since the third month. “Today our customers come from all over San Diego County, from Los Angeles, and from out of state.”

Making Progress
Just as women’s boutiques have evolved to encompass their own niche within HME, so have the products advanced to the point where breast forms are comfortable and realistic. The use of lifelike silicone forms, some with nipples and areolas, and advanced pigments, has moved prosthetics light-years ahead of the older forms that Reese likens to “a brick wall.”

“When I started, I could offer women only three products and you knew when you hugged someone if she was wearing a breast form,” Reese says. “There is so much progress in what the prostheses are today compared to many years ago, and the bras have come around tenfold.”

New technologies are also leaving their mark. “We are on the edge of radiant impression custom breast forms, which are molds of the upper body and surgical area,” Boerman says. “While at this point those are very expensive, and only some insurers are accepting them, I am nonetheless pleased to see that they are finally available.”

The ultimate goal is to restore women’s self-image. “I want my customers to leave the store looking every bit as beautiful as when they came in, and without exception I think my customers do leave feeling better, and looking better too,” Cook says.

Stores like The Brighter Side, Just Like You, Silhouette Shop, Fittings by Michele, and Naturally Yours also understand that their role is not simply to supply products—their clientele also needs a supportive environment where they can come with questions about their disease.

“Insurance has begun dictating how physicians can practice, and that has meant time taken away from patients,” Owens says. “As a result, we are often the first ones that patients can sit down with and talk about their experiences.”

Mental Healing
For women who have recently gone through surgery, this service component to providing postmastectomy products is invaluable.

“We complete the healing process in a way that the medical profession cannot,” Boerman says. “We do a lot of education because there is not enough, and because the information that is out there is not always easily found by those who need it.”

Because education is crucial to the success of the postmastectomy business and to the clientele’s state of mind, many boutiques have added health lectures, as well as skin care and nutrition classes, and hosted support group meetings. The boutiques also are designed to be comfortable and private, with staff that devotes considerable time to talking to customers about all aspects of getting a breast form or wearing specialty garments.

“We always include a hug and encourage them to call us with any questions,” Reese says. “They can’t absorb everything we have told them, especially when they receive the information so close to when they had surgery.”

Those in the women’s home health niche also go to great lengths to show their customers that life does not end simply because they are diagnosed with cancer, and to put them in touch with others who have been through the experience. For instance, Owens hosts an annual “survivor show” that features eight to 10 breast cancer patients modeling the latest swimsuits.

“The models talk to other women about how they were diagnosed and treated, and how breast cancer has changed their life in a positive way,” Owens says. “It is such an uplifting day, because those who are newly diagnosed see the positive in the experience, and that empowers them to go out and help others.”

For postmastectomy product providers, offering these services means earning more than just a healthy financial bottom line.

“We’re so lucky to do what we do,” Davis adds. “We love it so much and we are happy to be doing this. We definitely get back much, much more than we give.”

Elizabeth Finch is a contributing writer for Dealer/Provider.