Breast Cancer is the most common cancer that affects women. We often hear stories of the fight against the disease but rarely address the changes that come later. The breast cancer journey does not end with the end of the breast cancer treatment. The fight is tough, but the journey after is tougher.
Being diagnosed with breast cancer is life-changing and can affect a woman in many ways, beyond physical health. The emotional impact can be equally overwhelming – coming to terms with the diagnosis, as well as finding the courage to battle cancer and the determination to get through the treatment takes a lot of tenacity. During the treatment she may have to lose her one and sometimes both breasts to the cancer.
At the beginning let us understand that woman with breast cancer may be required to undergo surgery- mastectomy or lumpectomy. Mastectomy is the surgical procedure of removal of entire breast. Lumpectomy is removal of tumor and conserving the rest of the breast tissue.
Learning to embrace the physical changes in one’s body following breast surgery, be it a lumpectomy or mastectomy, is an emotional journey. It differs dramatically for every woman, naturally, because everyone’s personal view on body image is different and unique. One thing that is the same, however, is the fact that it has changed life permanently and that a healthy recovery takes priority over everything.
When having breast cancer and a mastectomy is inevitable, it is imperative that you take care of yourself mentally, emotionally, and physically.
It is common for the women to find that the bras that they used to wear no longer fit well, nor provide adequate support and even flexibility for their needs and that is where a mastectomy bra comes in.
A mastectomy bra is specially designed for women who have undergone mastectomy, with pockets for breast prostheses. These are specially designed pockets inside the cups to hold the prosthesis in place and prevent it from displacing.
A mastectomy bra is more than just a traditional bra with added pockets. It offers enough coverage to secure your breast prosthesis, soft materials for sensitive skin and lightweight support. They have extra wide under bust band, broad/ cushioned shoulder strap and no underwires.
The bra is intimately associated with a woman’s body image, and the struggle to find a well-fitting bra can cause both physical and psychological distress, hindering a patient’s sense of normalcy and well-being after cancer.
Even without breast cancer, women face challenges in selecting a properly fitting bra. Up to 85% of women wear an incorrect bra size.
Buying a bra is an art, not a science.
There is always a certain level of personal choice, preference and comfort that goes into buying a bra. What works for one woman following breast cancer surgery may not necessarily be right for the other.
What should you look for in a bra after breast cancer surgery?
The major components of mastectomy bra are:
Band: Band fit is of the utmost importance, as it holds your bra in place. The band should be snug and even all the way round the body. It should be at the same level in front and at the back. Make sure it is not too loose or too tight. As a guideline, you should be able to comfortably fit two fingers under the band of the bra. If the bra pulls away from your body easily, it is too loose. If you have trouble getting your fingers under the band and it feels uncomfortable, it is too tight. Extra wide bands with strong elasticity work the best.
Cups; The size of the bra cup you choose should fit your breast and/ or prosthesis comfortably. Initially fit the cup to your breast which is not operated or the larger size breast (in case of lumpectomy). Cups should contain the whole breast without any bulging at the top, bottom, or sides.
Cup separation: The center of the bra between the cups should sit flat on your chest.
Pockets: Mastectomy bras have pockets for your prosthesis with soft lining.
Straps: Wide, adjustable straps are most comfortable. Shoulder straps give additional support but do not carry the full weight of the breasts. Once again, be sure nothing is digging into your shoulders and skin or falling off the shoulders. Your straps should sit firmly on your shoulders with around a one finger gap when pulled on.
Closures: Front closures are recommended at first to make the bra easier to put on and take off.
Fabrics: Choose soft breathable fabric which feels comfortable against your delicate post-surgery skin. Choose a bra which has high cotton content. These will be gentle on your skin and help you stay cooler.
No underwires
A simple design: Details on the bra, like lace, may make it less comfortable.
Hook closures: When you buy the bra, it should fit you comfortably in the middle row of the hooks so that later if needed you can loosen or tighten the band.
Common Fitting Problems
The Band
The band is the most fundamental element of getting the right fit. It provides 80% of the support when fitted correctly, so it is important that it is not too loose yet not too tight. It should fit snugly around the narrowest part of your back and be of equal height all the way round, allowing room for just two fingers under the band. When the band is too loose, it will ‘ride-up,’ creating a rainbow shape on your back. It is tempting then to overtighten your straps to get the support right, but when the band is snug enough it will comfortably stay in place and reduce tension on the shoulder straps. If the band is too loose, your breast may spill under the band when you lift your arms over your head. We recommend fitting the bra on the middle hook of the fastener. This allows you to have room to loosen off as you ‘expand’ through the day or at different times of the month. It also allows you to have room to tighten as the bra wears and starts to lose elasticity. Check that the band is tight enough by raising your arms. The band should have little to no movement and stay in place.
The Straps
When you are confident that the band size is correct, the straps will only provide 20% of the support. You should adjust them to a position where they are not falling off your shoulders but also not too tight so that they are digging and creating a red mark on your back and shoulders. If the straps are falling off the shoulders they may be too loose, try tightening them avoiding over tightening.
The Cups
Your breasts and breast prosthesis should be fully covered by the cup, at the sides, top and bottom. There should be no wrinkling or excess fabric as this means the cup is too big and you should try the next size down. There should be a smooth line at the top of the cup and your breasts or breast prosthesis should not spill over the top or side. If this is the case the cup is too small, and you need to try the next size up.
The Centre Front
You should not have a gap between the centre of your bra and your body. If there is a gap, the cup is too small, and your breasts are pushing the band away - try the next size up.
Your Breast Prosthesis
If you wear a breast prosthesis, it is important to make sure you are fitting the cup of the bra to your natural breast side and not the breast prosthesis side. Your natural breast will change size due to weight loss or gain so if this is the case, we would advise changing the breast prosthesis to balance these changes.
How to calculate your bra size?
If you haven’t worn a bra in a while and don’t have one that we can use as a starting point it is advisable to take two measurements – the under bust and over the bust.
Example: 41- 38 = 3 inches
Find the number in the chart to get the cup size. 3 inches is the C cup size. Bra size is band size plus cup size: 38 C.
What is a Sister Bra Size?
Sister sizing means you can wear 2 sizes of bra and they should fit the same. So, if your original size is 34C and you cannot find it, go for its sister sizes of 36B or 32D. To get your sister size, you must go up a band size and down a cup size or if you go down a band size then go up a cup size. Even though that sister size is a B or D cup, the cup volume is still the same as the band size has altered by 2 inches.
How often you should replace your bra?
Replacing your bra regularly is one way to avoid an ill-fitting bra. But according to a survey conducted 70% of women said that their oldest bra is between 2-5 years old.
Get a New Bra Every 6-12 Months. The rule of thumb is that bras need to be replaced every six months, but sometimes this can be stretched to twelve months. If you wash and machine dry your bras roughly you can risk shortening their lifespan. But regular gentle cleaning and air drying will help your bras last longer.
How to decide that your bra should be replaced?
Other than its age, there are a few other things to look out for if you think your bra is due to be replaced.
Loose band and/or straps
The bra cups are losing their shape
The bra fabric is breaking down (compromising the bra's support)
Your size has changed
Your bra is just not comfortable
When should I start wearing a mastectomy bra?
All women and all surgeries are different, so your recovery time may also vary. Always consult your doctor before starting to wear breast forms or mastectomy bras. After surgery, your surgeon will recommend the appropriate time for you to start wearing a prosthesis. This will depend upon your medical condition, the post-operative healing process, and the type of mastectomy that was performed.
Knitted Knockers, India provides free Mastectomy Bras - Bras for Care, to underprivileged breast cancer warriers.
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