From the outside, the three story, baby pink Victorian style home looks like a dollhouse. A concrete path cuts through the full, green lawn and leads to large double doors. Inside, the rooms are filled with racks of long, printed dresses, simple floor length nightgowns, silk scarfs and jewelry displays. But, the last room is the most popular, and the most important. Through the doorway behind the glass chandelier are racks of bras and swimsuits for women recovering from breast cancer surgery. Each item has a discrete pocket for a silicone insert. 

Believe Boutique, Willamette Valley Cancer Institute

Located on 3^rd and Pearl, in north Eugene, Cynthia’s Fine Lingerie is a resource for womenbyproviding breast prosthesis. Women come to Cynthia’s for bras and prostheses that help fill out their original breast shape and balance following breast cancer treatments and surgery.  

“This can be a tearful place. Ladies are so happy when they get their breast and they get put back together,” says Joanne Erickson who has worked at Cynthia’s for fourteen years. “I always tell the women, ‘ This is the best part of the whole ordeal.’”

Cynthia’s serves women throughout the Western United States including Arizona, California, Washington, Alaska, Hawaii and all over Oregon. “The need is great,” says Erickson. “People think that breast cancer has gotten better, but I think it has gotten worse.”

The American Cancer Society estimates that 232,340 new cases of invasive breast cancer will be diag

Triangular breast prostheses at the Believe Boutique

nosed nationwide in 2013. Of these cases, many will result in surgeries that remove a portion or the whole breast. As an alternative to reconstructive surgery, breast prostheses help women regain their comfort and physique, without an additional reconstructive operation.

At Cynthia’s, next to the racks of bras and swimsuits, a door leads to a discrete room filled floor to ceiling with what appears to be white and light pink shoeboxes.  A tall, freestanding mirror stands at the far end draped in measuring tapes. 

Erickson enters the room and looks up at the shelves, bends down and pulls out a box from the bottom shelf. She takes of the lid and carefully pulls out a nude-colored triangular silicone prosthesis. It is flexible, yet holds its shape resembling the front of a breast. It’s a smaller size, maybe meant for a B or C cup, but because of the silicone it also weighs about the same as a real breast.

“The doctors now send their patients here before surgery and we try to educate them on what the products are for and what’s available to them,” says Erickson. “After surgery sometimes we talk about reconstruction, if that’s their choice and what they want to do, but a lot of them feel that after surgery they have been through enough and they don’t want to do anymore. In that case, we fit them with breast prostheses and mastectomy bras.  It’s the first time they’re coming to a place that isn’t sterile and they’re more comfortable here.”

After a woman has healed from surgery usually about six weeks, she is eligible for a prescription to get fitted for prostheses. Depending on the area of incision and how much tissue was removed, the prosthesis help to recreate the look of the breast to return her balance and shape. Teardrop shape prosthesis is associated most commonly with lumpectomy surgeries as the shape is only designed to fill a partial-breast. However, triangular prostheses are more appropriate following mastectomies or when larger portions are removed explains Erickson.

At The Believe Boutique in the Willamette Valley Cancer Institute, volunteer Melinda Plummer fits women with breast prosthesis as a free service through the American Cancer Society. The boutique serves women with breast cancer and gives them free prosthesis from supplies that are exclusively donated.

“It’s really gratifying to watch them in the boutique because most of the women can’t believe that it’s a free service available to them,” says Plummer. “Some didn’t think that they really wanted to get implants or they didn’t think they wanted to mess with a prosthesis but when they find out how real and how comfortable they can be and what a difference it can make when they try it on and put their shirt on and go ‘oh!’

Plummer has volunteered at the Believe Boutique since it opened in January 2012 at the Willamette Valley Cancer Institute. She has developed relationships with the women who regularly come in for treatments because the Boutique is located in the same building where many of the women receive their chemotherapy and radiation treatments.

Inside the Believe Boutique, the vanity along the left wall is stocked with a variety of patterned scarves and colored hats.  A large mirror reflects two dark red velvet curtains on the opposite wall. Behind the curtain on the right is a dressing room with a closet full of shoebox-like containers. Underneath the lids of these boxes are bras with the internal pocket for a prosthesis.

Behind the curtain on the left are cabinets with the teardrop and triangular nude colored prostheses and fiberfill foam breast forms.  Plummer is the only volunteer certified to fit breast cancer patients for prostheses and, in her experience, she has never had anyone take the fiberfill breast forms.

“[The silicone] is more natural and it feels real. I guess it would be like a padded bras versus the real thing,” says Plummer. “When people come in here and especially if it’s free and if they can get a prosthesis, they’re going to take one.”

In both styles of prosthesis, there are options between fiberfill and silicone material. The fiberfill is lighter, but women popularly choose the silicone to create a natural looking breast in both weight and movement says Erickson.

If the cancer is caught early and localized, the woman can undergo a lumpectomy, which removes a smaller portion of the breast.  These treatments leave women unbalanced in both size and weight.  Backaches, and poor balance and posture are the medical incentives for wearing prosthesis, but many women choose to wear prostheses for their own comfort. Prosthesis, says Erickson, can make women feel more comfortable by balancing them out. 

Breast cancer affects ­­­one in eight women in America and many of these diagnoses require surgery.  A mastectomy, as opposed to a lumpectomy, removesthe whole breast, sometimes both, to ensure that all of the cancerous cells are removed.

Katie Burke, the Patient Navigator at the Willamette Valley Cancer Institute and leader of the Young Women’s Support Group, finds that choosing a prosthesis over reconstructive surgery is dependent on a woman’s age and where she is in her life.

One of the women in Burke’s support group underwent a unilateral mastectomy, which only removed one of her breasts. She began the process of reconstruction, but stopped because in some reconstructions, the doctors might have to operate on the other breast as well, and she didn’t want the doctors to touch her other side.  

“She hated it,” said Burke. “There was no way she was going to get her breast back, so she would rather wait so she could keep her other breast in case she was able to get pregnant again, she would be able to breast feed.” She now wears a prosthetic with the option of reconstruction available further down the road.

As a breast cancer survivor, Burke, who was 23 years old when treated, chose reconstruction over wearing prosthesis. “I just wanted to feel a little bit more comfortable in my skin,” says Burke. “Being able to wake up with looking somewhat normal was, what I felt like, encouraging.”

“I think young women are more likely to go for the reconstruction because, in their minds, it is something that is more long term, says Burke. “For older women their tissue tends to be a little different, so reconstruction tends to be more painful. A lot of times because they are older, they have the mentality that reconstruction isn’t necessary. But to me, age doesn’t matter. It’s more about what you’re comfortable with.”

The popularity of breast prosthesis results from women avoiding a dangerous and invasive breast reconstruction surgery that adds longer healing time to their treatments says Erickson. Although they should avoid wearing a prosthesis in the weeks following their surgery and treatments, prostheses are prescribed by oncologist and often covered by patient’s health insurance.

Most women recovering from breast cancer are allowed one prosthesis every two years that is covered by their insurance through companies like Medicare that, in addition, allows the women as many bras as they want says Erickson. On the downside, companies like Blue Cross only limits their client’s coverage to four bras and two prostheses per year.

The prostheses have a two-year warranty, but Erickson encourages her clients to get another prosthesis as soon as they are eligible for a new one. The normal wear and use of the prostheses breaks down the material and can potentially cause leaks and air bubbles. Other factors such as how large the prosthesis is and if it is being worn every day shortens the lifespan of the prosthesis. Nevertheless, Erickson encourages the women to wear their prosthesis every day, regardless of the size.

Cynthia’s works directly with the local oncologists and help the patients find the correct prosthesis and bra. The goal is to fit the woman as close to her original cup size as possible says Erickson.

While at Cynthia’s, Erickson notices that the women with smaller breasts are often more eager to get their prosthesis sooner than the larger chested women. “The smaller they are the more they want that breast back,” says Erickson.

Erickson recalls a woman who came in to Cynthia’s with her husband following surgery. Even though she was a small size, she was desperate to not be seen without wearing a prosthesis. She went to the back room, put on her prosthesis, put on he top and asked her husband, “Do I look better?” He replied, “Do you feel better?” She nodded and he said “Then that’s all that matters.”

 “The patients come here a lot of times crying. They don’t know what to expect. And I’llsay nine out of ten time they’ll leave here laughing and feeling good about themselves and hugging us. And that makes us feel really good,” Joanne Erickson.

Other than the financial cost of prostheses, women are self conscious about their breast and do not want to ask. “It’s really individualized,” says Plummer. “Some women don’t want any reconstructive surgery. They’ve had their mastectomy and that’s all the cutting they want, so they’re really happy just to have their prostheses.”