Medical discussion of mastectomy is quick to become complex. The definition of mastectomy is simple enough in itself – meaning removal of breast tissue. Either partially or completely. It’s when you get to the reasons why we’d choose to have a unilateral mastectomy (one breast removed) or a bilateral mastectomy (both breasts removed) it starts to get interesting. And, across all that, mastectomy bras are there to provide us comfort, balance, security. They’re also able to help us maintain our confidence and self-esteem.
We’re going to discuss unilateral mastectomy separately from bilateral mastectomy here. The reason is because, although they’re essentially the same procedure on a ‘micro’ (or closeup) level, there are other considerations. On the broader level there is much to consider. Considerations are about: body balance, reconstruction, prophylactic (preventative) mastectomy, flat, recurrence of breast cancer, contralateral breast cancer, and so on. Then, there’s the considerations of whether lymph node biopsy will take place. Then, the implications and consequences of that on the body. The selection of mastectomy bras available are largely the same whether we’ve opted for a bilateral mastectomy or unilateral mastectomy. However, our choice of what to wear may differ based on relevant considerations.
Why Unilateral Mastectomy
Unilateral mastectomy is one method of treatment to remove cancer when given a diagnosis of breast cancer. In times past that seemed a reasonable approach. With the cancer dealt with, the other breast was generally considered no more likely to develop cancer than the first one had been. Then, a woman would wear a breast form in a bra or have a reconstruction of the single breast. There were no such things as mastectomy bras back 40 years ago when my mother had her unilateral mastectomy. Thankfully, we’ve come a long way in terms of choice, comfort and options for physical health and self-esteem.
Today, women can still be advised that, as they are no more likely to develop breast cancer in their second breast than they were in the first breast, a unilateral mastectomy is sufficient. Just because Angelina Jolie brought the concept of a prophylactic bilateral mastectomy into the open, doesn’t mean we all need to do that, we’re told.
More Women Choosing Bilateral Mastectomy
However, it seems more women are opting for double or bilateral mastectomy than in the past. Among women having mastectomy, rates of contralateral (the other breast that didn’t have cancer) prophylactic mastectomy have increased from less than 2% in 1998 to 30% in 2012 (Source: https://jamanetwork.com/journals/jamasurgery/article-abstract/2776218). Societal, financial and health team support were cited reasons for this increase. This is despite there often being little apparent evidence that there is a medical reason to do so. That is, the breast cancer risk in the other breast is low. And further, the risks associated with surgery and recovery still remain.
Not Everyone Opts for Reconstruction
Interestingly, despite breast reconstruction becoming more practiced and common, not everyone chooses it apparently.
A UK Health Research Authority “audit found 31% of 16,485 women chose to undergo reconstructive surgery, suggesting that it may not be the preferred course of treatment following mastectomy. Furthermore, some researchers have found no significant differences in psychosocial outcomes between women who have undergone mastectomy with women who had mastectomy with reconstruction.”
What Does This All Mean?!
To be clear:
Our discussion here is around the requirements women have for mastectomy bras to meet their needs. For up to date and factual information about breast cancer and breast cancer treatments, please do consult appropriate medical professionals to advise on your particular circumstances.
We haven’t been able to drill down the numbers – yet. But the evidence we have found shows many women are undergoing unilateral mastectomy to treat a breast cancer in that breast. And, they are not all undergoing reconstructive surgery on that breast.
Before researching the implications and consequences of unilateral mastectomy, we hadn’t considered how mastectomy bras would be playing any part in women’s well-being. That is, besides the obvious cosmetic application. Which of course is enormously important when it directly affects self-image, self-esteem and mental health.
However, evidence suggests that mastectomy bras have a further role to play in women’s well-being following unilateral mastectomy.
Unilateral Mastectomy May Affect the Spine
A study from 2016 showed that “Mastectomy is known to effect body posture after a change in the center of gravity of women due to a missing breast.” The researchers went on to “recommend informing the patients of the possible change in body posture in the long term, which should be supported or limited with physical therapy.”
So, evidence suggests that for a woman who has undergone unilateral mastectomy and not had reconstructive surgery of that breast, it is important to wear mastectomy bras with a breast form to provide some balance. Smaller breasted women may be less affected by imbalance. But apparently even an A cup sized breast weighs almost 250g / 0.5lbs.
Women with an imbalance from living long term with this type of body imbalance say it can lead to neck, shoulder and back pain . And clearly the larger the remaining breast is, the more it weighs and the greater the imbalance. A mastectomy bra and breast form is unlikely to completely balance the body perfectly. However, it’s an easy and logical place to start. And, it’s a recommendation from the mastectomy bra manufacturers. They know from experience how the balance of the breasts affects the female body.
Mastectomy Bras – What to Wear Post Surgery
Your surgeon or medical team / breast care nurse will advise how to care for your surgery site. If they recommend a surgical bra, the bras we have reviewed over at our Buying Guide HERE are suitable bras for post breast surgery and in the recovery period. These bras are generally soft on tender skin, including when radiation therapy is part of your treatment.
Of course, you can continue to wear them any time after that you like! But most designs are for early after surgery, and so are more sporty-looking (some surgical-looking). Whereas after the initial recovery period, many mastectomy bras look just like ‘normal’ bras. Good mastectomy bras have the added benefit of being a pocketed bra which can take a breast form.
A soft, light, fabric-covered temporary breast prosthesis (‘form’) is usually offered to women to wear after surgery for a balanced look. These can move around or ride up, and even pop out! So, quickly stitch or pin it inside your clothing or bra to keep it in place! Once you’ve completely healed from surgery, there are other options. Then, it’s possible to then have a more permanent style of breast prosthesis to wear with your mastectomy bras.
You may also like to consider a Mastectomy Pillow to help with recovery. We have reviewed some of the very best available over here: 9 Best Mastectomy Pillow Options | Product Reviews and Buying Guide.
Mastectomy Bras for Every Day Living – Longer Term
Longer term, once surgery is all over and your body is fully recovered, there are many, many options for bras. And, many of them are so very lovely! Good mastectomy bras have various features to help them do their job well, and we’ll discuss them in a Buying Guide and Product Review article we are currently working on for you. But essentially, mastectomy bras need to double as what is known as a ‘pocketed bra’. This is so that a breast form or breast prosthesis can be inserted and held in place to take up the space where our breast was and make us look balanced.
It can be a scary, painful, costly, and long journey. But our wish for you is that you are well informed, cared for, have a full recovery and full and fun life. Our cosmetic outcome is really important to some of us, me included. And, we are fortunate in this day and age to have many more options available to us than there have been in the past.
Shona X
Sources:
Physical Effects of Unilateral Mastectomy on Spine Deformity https://pubmed.ncbi.nlm.nih.gov/27876481/
Bilateral Mastectomy in Women With Unilateral Breast Cancer https://jamanetwork.com/journals/jamasurgery/article-abstract/2776218
Women’s Experiences https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/womens-experience-of-unilateral-mastectomy-without-reconstruction/
Breast Reconstruction Audit: https://digital.nhs.uk/data-and-information/publications/statistical/national-mastectomy-and-breast-reconstruction-audit-annual-report
Neck, Shoulder and Back Pain Due to Imbalance After Single Breast Mastectomy https://onlinenetwork.bcna.org.au/discussion/16350/neck-shoulder-and-back-pain-due-to-imbalance-after-single-breast-mastectomy
Impact of mastectomy for breast cancer on spinal curvature: https://onlinelibrary.wiley.com/doi/full/10.1111/tbj.14018
Mastectomy: https://www.mayoclinic.org/tests-procedures/mastectomy/about/pac-20394670
Going Without a Prosthesis: https://breastcancernow.org/information-support/facing-breast-cancer/living-beyond-breast-cancer/your-body/breast-prosthesis/clothing-swimwear#going%20without%20a%20prosthesis
Optimizing Symmetry after Unilateral Mastectomy and Reconstruction: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8673962/