A significant number of women with breast cancer decide not to have reconstruction. This can be for a variety of reasons; the patient is comfortable with the idea of living without her breast(s), or her partner or family are convinced that reconstruction is unnecessary. Unfortunately though, we frequently notice that this decision is based on inaccurate or incomplete information. Obtaining the correct information from peers, patient support groups, academic publications, relevant websites and medical personnel that are involved in breast cancer treatment, can help you make the right decision.
In breast cancer, complete oncological treatment always takes priority over the reconstructive procedure. This includes a swift and professional diagnosis, correct ablative surgery, adequate adjuvant therapy (radiotherapy, chemotherapy and hormonal therapy) and finally good out-patient follow-up. However, once the cancer treatment has been completed, you will be faced with the consequences of your oncological treatments and over time, the aesthetic aspects assume an increasing level of importance. Obtaining the correct information about breast reconstruction before starting treatment, and simultaneously addressing the oncological and aesthetic aspects, will result in a superior cosmetic outcome without influencing the quality of the oncological treatment or long-term prognosis.
An external breast prosthesis is one option (fig.1a&b). This is a teardrop shaped silicone device that can be added to a bra to imitate the breast shape. It can be worn either loosely, in a specially designed bra, or attached to the chest skin by an adhesive support. Different sizes and shapes are available. The external prosthesis can be a temporary solution whilst awaiting surgery or be a permanent device. The main advantage of an external prosthesis is that no additional surgery is required. The major drawback is that an external prosthesis has to be replaced every day and is sometimes difficult to combine with certain clothing. For many patients an external prosthesis remains a stigma, constantly reminding them of their breast cancer.
Fig. 1a Fig.1b
Benefits of an external prosthesis:
- Artificially restores the natural shape of the breast.
- Avoids further surgery.
- The external prosthesis can easily be exchanged, if the volume of the other breast changes.
- An external prosthesis is often reimbursed by public health care systems or private insurance companies.
Disadvantages of an external prosthesis:
- Wearing low cut dresses or blouses can be more difficult than following surgical breast reconstruction.
- The prosthesis may feel heavy, cold, or warm and sweaty, leading to skin irritation.
- A loose prosthesis can move and sometimes slip out of a bra. It may be necessary to wear a special bra or adapted clothing to prevent this from happening.
- Certain sports or hobbies can become more difficult, unless a specific support garment is worn, for example, a specially adapted swimsuit.
- The volume of the prosthesis does not change with fluctuations in weight, although a different prosthesis can be bought.
An external prosthesis can be purchased in specialty lingerie stores or orthopedic shops. Get advice from personnel who specialize in measuring and modifying such prostheses