Kim Fellner poses wearing a bra with a silicone breast prosthesis inside. She writes that finding a prosthetic breast was more difficult than she expected. (Allison Robbert for The Washington Post)
Who knew it would be so hard to find a replacement boob?
I wasn’t eager to have this information, but when a stubborn sarcoma invaded my left upper chest and required a modified radical mastectomy, I found myself in the market for a viable substitute.
I’m not alone. The American Cancer Society estimates that nearly 317,000 women will be diagnosed with invasive breast cancer this year. Of those who have a mastectomy, it is estimated that more than a third will, for personal or medical reasons, opt against breast reconstruction.
Although I was not technically a breast-cancer patient, I was faced with the same dilemma. Given the surgical requirements and an uncertain prognosis, breast reconstruction was not appropriate. So, if I wanted to remain visibly double-breasted, an external prosthesis seemed the way to go.
The process proved more complex than I had imagined. Despite living in a big city — Washington — I could not find a single brick-and-mortar store to visit to compare my options. And since finding an adequate replacement breast requires that you “squeeze the merchandise,” the internet proved confusing and unsatisfactory. I was ultimately successful, but I had to do a lot of sleuthing to get there.
My journey into the land of prostheses started in March 2023, when the odd pearl-sized lump I had found in my chest was diagnosed as Ewing’s sarcoma — a mean and exceedingly rare cancer that usually afflicts teenagers. Because I was 74, it was the last thing doctors at Johns Hopkins expected. The jokes about being young at heart quickly got old.
To deter spread, I undertook five arduous rounds of inpatient chemo at Sibley Hospital in D.C. Thanks to my splendid doctors and nurses, plus a vibrant support network of family and friends, I sailed through.
A modified radical mastectomy
The cancer, however, was undeterred.
A year after my Ewing’s diagnosis, a modified radical mastectomy removed my left breast and most of my major pectoral muscle.
The need for a mastectomy caught me by surprise and made me seriously upset, but there weren’t many options. My sister (a doctor) and my caring oncologist both made the case for going breastless rather than lifeless. “I know it’s a shock,” my sister commiserated, “but you really don’t need that breast to live a perfectly decent life.”
The week before the surgery, I stood in front of the mirror pressing my left breast flat, trying to envision my impending lopsidedness. And I took a few photos of my double-breasted self, rather like the snapshots they recommend as mementos when you finally get rid of your mother’s teapot.
Oddly enough, it worked. When I woke up in the post op room, even with my chest swaddled like a mummy, I knew that I was still myself, my spirits and sexuality intact.
The big reveal about three weeks later was startling, but not as shocking as I expected, although I think it would be much harder were I younger. True, my nipple was now in a rather odd place, higher up on my chest and left of center; and a red crescent scar extended from my sternum to my armpit, along a bony ridge where the pectoral muscle had once been. But unlike the flat landscape I had imagined, there was some contour, and my surgeon had graciously sculpted a hint of cleavage.
Slipping through the cracks
Because the sarcoma was in my chest and I was not a breast-cancer patient, I had been accidentally excluded from the counseling usually extended to the newly breastless. The resource person in the surgeon’s office eventually gave me a few minutes of her time and a puff stuffed with fiber batting that could roughly mimic my remaining breast; it could be slipped into a bra lined with a pocket to keep it in place.
Where to check out more sophisticated options? A number of shops had closed during the pandemic, and the list of recommended options was meager. An online search suggested that the closest place to purchase a prosthesis was a suburban Nordstrom. So I made an appointment and trekked off to meet the store’s resident prostheses fitter.
After informing me that I didn’t have the proper paperwork for Medicare reimbursement, the no-nonsense saleswoman agreed to show me the store’s lone silicone prosthetic option.
Having seen many variations online, I knew there were many different materials, shapes and weights. How was I supposed to know whether this would be my best choice? As to the bras into which this jiggly form was to be placed, they were uniformly ugly, uncomfortable and beige. “Hey, I only lost my breast, not my sense of style,” I told the saleswoman. She chuckled. My search continued.
Cheap sports bras
Meanwhile, I outfitted myself with sports bras from Target and Amazon, which were comfortable, cheap and lined with pockets for removable pads, in which I tested various falsies I had ordered online. They weren’t perfect, but most were a step up from raiding my sock drawer.
But I still wanted to explore my silicone options and, at roughly $300 for a single breast, I was reluctant to take my chances online. The social worker managing cancer survivorship at Sibley had one suggestion: an outfit called the Pink Lily, in Virginia, that makes “house calls.”
That was too good to pass up. I went to the website, left a message and soon connected with owner Alex West. And the next weekend, there she was at my door, rather like a Tupperware lady, except carrying a large basket full of various replacement boobs and bras. Over the next hour, she viewed my mastectomy scar, shared what she had learned over the past 13 years and showed me options.
A life-changing business
How on earth, I asked, had she gotten into this line of work? About 16 years ago, West said, she had accompanied a friend who was leading classes for women who had been treated for breast cancer.
“You'd see this group of women come together and the metamorphosis that occurred just with some makeup, some scarves, some wigs, some breast forms, it was miraculous,” she said. “So, after 35 years in financial services I was looking for something different, and I felt a strong leaning to do that, to connect more women with those opportunities.”
West started an online business offering prostheses and began promoting the site to doctors. Several years later, when she herself was diagnosed with breast cancer, she became even more determined to address the need. Now, at 66, her health is good and the business is flourishing.
When Inova Fairfax Hospital in Fairfax County, Virginia, built its new cancer institute, West helped open a boutique near the gift shop, where patients can check out their options for prostheses, wigs and other supplies that can ease the cancer journey.
Thanks to West, I was finally able to purchase two appropriate silicone prostheses, one for every day and one for a swimsuit. It set me back $450, but I think it was worth it.
What to keep in mind
Here’s what I’ve learned:
Surgeons’ offices vary widely in the quality of postsurgical counseling they offer, but many hospitals provide other programs and social workers to help breast cancer survivors. Ask other women who’ve been through it to find out what they did. And trawling the internet, while frustrating, does give you a broad sense of what’s available.
The silicone breast feels the most realistic and is less likely to shift around. It keeps its shape and doesn’t require much adjustment. But it is also a bit heavy.
The bra where you’ll put the prosthesis is as important as the prosthesis itself. Through a friend, I finally found a bra that offered wide straps, solid support and an over-the-head style that felt comfortable without being dowdy. I cringed as I paid roughly $100 for it, but it’s been worth it.
As with so much in our health-care system, privilege and income disparity are major factors in who gets what. Navigating the options takes access to information and time to do the research. And the better stuff is expensive.
Medicare provides some reimbursement for bras and prostheses, but it requires lots of paperwork. West says a lot of women give up on the process.
Bottom line: See what works for you. I like the silicone option, but I have one or two lighter puffs as well. And, in a pinch, socks will do.
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