Bras & Breast Cancer
You would imagine that there isn’t much to say about bras. A bra is a bra…is a bra, right? You’ve been using them for decades now. Yet breast cancer puts you in a whole new category with bras, especially following your surgery.
Here's what you need to know about bras and breast cancer:
First off, don’t buy any bras for six
months to year following surgery as your breasts will need time to heal. If
you’re having reconstruction surgery performed, your breast(s) size will change
constantly, especially if you have expanders. We all know bras can run anywhere
from $35 to $80 or more, so why waste your money, wait until you’re fully
healed and then go to Fredricks of Hollywood or Adore Me and splurge on the
girls.
Instead of running out to purchase a bra, ask your physician to provide you with a few pairs of surgical bras. These bras are made of soft cotton material with front closures. They come in white, beige, or black. You want to avoid back closure bras as this will put some strain on your chest as you try to reach behind you to close the bra; there's no doubt you will find trying to close the snaps a bit difficult, especially for the first week or so after surgery. Anyway, these surgical bras come in small to 2X. Also, your physician or your nurse navigator will typically give these to you in their office. Take two or more if they offer. Ask them to write a prescription for two or three more bras. (Bras get dirty and stained fast after surgery—and as you'll have seepage from the sutures as you heal, you'll want to wear a clean bra daily to avoid and/or minimize the potential for infection. Sometimes, you'll have to ask the physician for these.
This bra prescription is typically covered under “durable medical equipment.” Yes, your insurance covers these bras. Don’t let anyone tell you otherwise. You’ll often hear the doctor’s stuff say, “oh, your insurance doesn’t cover that…,” however, many times, it’s because the person doesn’t want to do the paperwork or they don't really know; thus, ask them nicely to, “please prescribe it anyway” and you can discuss it further with your insurance. Yes, Medicaid covers these bras. Unfortunately, I have found many medical staff members complacent and unwilling to “do paperwork” or “jump through hoops” for their patients. You will at times have to advocate for yourself a little more adamantly. It’s their job! Ask that they do it. Remember, you’re going to be paying out-of-pocket for lots of other things, thus, saving $20 to $60 for these surgical bras means you can pay some of those bills that are piling up. Always have your physician write a prescription for anything you need! Don’t let pride or frustration get in your way.
An alternative to these surgical bras, as time goes on, are sports bras. Again, I recommend finding the ones with front closures, this way you won’t put any strain on your chest, and it’ll be easier, and definitely less painful, to slip your arms into the straps and close the bra in front. Yes, you’ll still experience pain and sensitivity for months—and let me be totally honest, even years—following your surgery. These front closure bras will also work best if you have surgical tubes left in place after surgery. They are also more convenient allowing you to place gauze pads over your chest prior to closing the snap in front. This beats trying to balance the gauze pads on your chest as you try to close a bra in back or pulling your bra from your skin and stuffing gauze pads down the front of your bra. Take about childhood memories!
If you can’t find the front closure sports bras, use regular sports bras which have the more flexible material in the “breast cup” area. Also, search for ones that have a two-to-three inch gap between the breast area and the bottom of the sports bra where the elastic is. This will allow you to pull the sports bra down a little lower to avoid placing the elastic over your sutures; and later as you heal, the suture area otherwise, you will feel discomfort in the area.
Bralettes are cute and seem easier to use, however I wouldn’t recommend them until after you’ve healed from surgery. As my plastic surgeon informed me, you need a “real” bra to hold your breasts in place and not put strain on the sutures. Thus, following his advice, it’s better to wait until your further along in your healing before using bralettes as they have no real support.
Avoid using underwire or bras that are too
tight. These will put pressure on your surgical site especially if your surgeon
cut under the breasts—where your breasts curve and hang. I will warn you now that
you will experience discomfort from surgery for quite a few months regardless
of whether your surgeon cut under the breasts or across the center of your
breasts. It's normal to feel pressure and sensitivity; however, if you experience extreme pain, consult your physician immediately.
Mitigating breasts pain:
One thing I found that reduced the pain in
my breasts after surgery, was wearing a thin cotton tee-shirt under my
bra—against my chest. Yes, you read correctly, under the bra; this provided a
little cushioning between the bra and my sutures and reduced some of the
discomfort from the elastic in my bra. Basically, I would place the xeroform strips over my
sutures, place the gauze pads on top of the xeroform, put on my t-shirt,
shaping the t-shirt so it would lay flat against the area, then I would put on my bra
over the t-shirt. This not only lessened the discomfort, it also provided an
extra level of hygiene.
Empty bras cups:
Another reason to wait till you fully heal to
purchase a new bra as your breasts will fill your bras differently. Your
cup size may have changed. I went from DD+ to a B-minus cup size; needing a size 42 width made it almost
impossible for me to find a B-cup in a size 42; that size typically only comes
in cup size C. Thus, leaving a gap between my breasts and the bra, and when I
put a blouse on, it looks funny...as if you can squish the material of my bra.
You can also experience the “empty bra” space when you lay back as your breasts
may fall gently to the sides. This can be a bit embarrassing when your partner
notices the gag and brings it to your attention. Consider going to a boutique which
specializes in bra fittings or prosthetics to obtain the correct bra for
yourself. Yes, these mastectomy bras should be covered under durable medical equipment. Remember, your physician needs to prescribe them--yes, on a prescription pad or log in the prescription on your chart in their computer. If your doctor doesn't prescribe it, your insurance won't pay for it.
Staying Flat:
If you are like thousands of other women who had
a dual mastectomy and opted to stay flat—an appropriate and valid choice if
that’s your desire—you can decide whether or not you wish to where a bra or use
a slip under your blouses once you’re healed. However, at the beginning, you’ll
need the aid of a bra to hold up those gauze pads. As one surgeon stated to me,
you’ll also need a bra to reduce the pressure on your sutures which gravity causes.
Once healed, you can decide whether you wish to wear a bra or any underwear
cover on your chest. If you had a dual mastectomy and kept your nipples, you may
wish to wear bras or braletts to cover your nipples to keep them from protruding
against your blouses.
Hygiene:
Let’s talk about hygiene for a moment. After
surgery, you will have to change gauze pads that are on your breasts to keep
your wounds clean and reduce and minimize the risks of infection. Regardless of how careful you are, you will get blood on your bras. Additionally, as you
begin to heal, your sutures will scab over with dried blood, and if your
physician prescribes any ointments to place on your breast(s), this too will
soil your bras. If you are using xeroform to help with healing, this will
turn your bras yellow and again, stain the bra. Thus, as you can see, your bras
will get dirty quickly, hence my recommendation to wait until fully healed before purchased any new bras and having your physician
provide you with a few pairs of surgical bras from his stash and prescribing at
least two or three more. You don’t want to use the same bra daily. If you're alternating between two bras daily, washing them by hand daily may leave them a bit damp if they'd not tossing them into a dryer which can potentially introduce bacteria and lead to possible infection. Definitely, something you want to avoid despite the high dose of antibiotics you'll be given up front. (Side note: if you're prone to yeast infections, you'll want to ensure your physician prescribes DiFlucan or some other medication along with the antibiotics to avoid a yeast infection. It's horrible suffering from pain above and below simultaneously.) Let’s stay on the safe side.
Note: Xeroform Petrolatum Dressing Patches are covered under Durable Medical Equipment. And yes, you will need to cover these with gauze pads otherwise they will seep through your clothing and make you appear like your “nursing”. These patches do stain your clothing, thus be sure to put the gauze pads on top of them and your bra on top of that. Having that additional barrier of a sleeveless t-shirt will help with minimizing staining to your blouses.
You’ll want to consider hand scrubbing your bras to get the guck out of them before tossing them in the washer. I found that using one of those small scrub boards, like our grandparents used, works wonders to help clean the bras and t-shirts.
A word on prosthesis—the fake boobs.:
These
are definitely covered under durable medical equipment, and you will need a prescription
for them. These are typically prescribed after a month or so following surgery
when you’ve started to heal. Speak to your physician about these. You may need
to be fitted for special bras to hold these prostheses. Again, speak to your
physician and have them refer you to a breast cancer prothesis apparel shop.
The women working in these shops will help you find the correct bra you’ll need,
and they are often very understanding and respectful.
As I mentioned early, avoid purchasing new regular non-surgical bras for at least six months to a year following surgery as your breasts are still healing; you’ll merely waste your money as the size you buy may not be the size you ultimately need and as you already know, bras aren’t cheap. If you’ve had a dual mastectomy and are going for reconstruction, wait until you’re fully healed as the extenders will change your bra's cup size continuously. I know it’s important for you to feel sexy again, I know that feeling well, I experienced it often myself; however, delay the gratification for a few months then go to Fredricks of Hollywood or Adore Me, or some other fancy bra store and splurge on the girls. For now, sports bras with front closures are a good stand-in. Then again, it’s your money, purchase what you want, when you want it, if that makes you happy and makes you feel good.
*Note: Each state...and country...is different in how they hand prescriptions of "medical durable equipment; however, do not let that stop you from advocating for yourself and requesting your physician and their staff provide you with the prescriptions for items which your insurance company may cover.
This is an excerpt from Dr. Charley Ferrer's new book, Breast Cancer 101: What you should know about aren't told. The planned release date is October 2024. If you wish to pre-order your copy, please email us.