When you're first diagnosed with breast cancer, all you can think about is "Am I going to die?" But as you begin to learn to live with your cancer diagnosis, you start to think about other things, like "What am I going to look like bald?" It may sound frivolous, but ask any breast cancer survivor and she'll tell you that she thought a lot about whether to splurge on that real human hair wig or what she'd look like in a swimsuit.
Feeling good about how you look is an important part of feeling good about yourself in general. And no one deserves to feel good about herself more than a woman who's surviving breast cancer. Fortunately, women with breast cancer today have a mind-boggling array of options, from wigs and scarves to specialty bras and swimsuits, designed with their needs in mind.
Not Your Grandmother's Mastectomy Bra
When Theresa McLeod started fitting mastectomy bras in the 1970s, there were three bras and two breast forms. Today, in the boutique she manages at the Evelyn Lauder Breast Center of Memorial Sloan-Kettering Cancer Center in New York, McLeod stocks a running inventory of about 3,500 bras in 30 to 40 styles. They range in sizes from 32A and AA up to 52DD. "You can really get anything you want," McLeod tells WebMD. "Within the last three to five years, options have really expanded. You can get microfibers, V-cut bras, lace appliques, and a huge selection of seamless styles."
Kate Rubien, manager of Underneath It All, the boutique at the Clinical Cancer Center at New York University Cancer Institute, agrees. "Not long ago, we were excited to get black," she says. "Now we have all kinds of colors -- one bra comes in mint green, blue, burgundy, and pink. We stock some bras that look just like expensive Wacoal bras."
Mastectomy bras still look a bit different than regular bras. Because they include pockets for breast prostheses, they often cover much more of the breast than do regular bras. But you can also ask to have a pocket sewn into your own bra to accommodate a breast form. The department store Nordstrom will do this to any bra they sell, or you can ask at the hospital where you're being treated.
You should be fitted for a mastectomy bra by a certified fitter. Most cancer programs either have boutiques that do fittings or provide referrals. But once you've gotten a good fit, you can buy beautiful mastectomy bras online. Nordstrom and JC Penney also carry mastectomy bras. Most insurers will pay for at least one mastectomy bra per year (along with coverage for prostheses). Check with your carrier about coverage.
If you've had a lumpectomy and don't need a full breast prosthesis, you may still want to get a small breast form for symmetry. "It's like filling in a missing piece to the puzzle," Rubien tells WebMD. "I have eight different styles of partial breast forms -- different shapes and thicknesses -- in a full range of sizes." Or you may prefer a "molded cup" bra that is pre-shaped and easily filled out.
Other options available include a soft camisole that women can wear during their post-surgical period with pockets to hold drainage tubing and bottles. Many insurers also pay for one of these, says McLeod. There is also an array of self-adhering nipples and nipple covers for women in various stages of reconstruction.
In the Swim
Like bras, swimsuits for women who've had breast cancer have taken a great leap forward over the past several years. "The suits are out of this world," says Marianne Kelly, founder and director of the Image Recovery Center at the Sidney Kimmel Cancer Center at Johns Hopkins Medical Center. "There are two-pieces, one-pieces, skirted suits, tankinis, detachable skirts, sarongs that match, and more athletic suits that fit higher at the top and provide more support."
The most up-to-date, contemporary swimsuit styling comes from a line called Anita, Sloan-Kettering's McLeod tells WebMD. "They have the most stylish, but they're also higher priced," she says. "Amoena also has a fabulous line, and we rely on them for a lot of body styles that other manufacturers don't make, like a blouson suit."
The most popular swimsuit style for women who've had a mastectomy, says McLeod, is the tankini. "When you're wearing a one-piece suit, every time you have to take it down to go to the bathroom, the breast is going with the swimsuit. Women have just snapped up the tankinis, and there is a wealth of designs in sizes from 6 to 26." Other companies making mastectomy swimsuits include It Figures, T.H.E., and Gottex.
Kelly would still like to see manufacturers offer some other options, like yoga tops. "I think it's something we'll see in the future -- more athletic and sportswear that will allow women a little more freedom about wearing prostheses and feeling confident."
From the Top Down
For women undergoing chemotherapy, hair loss can be extremely traumatic. Having the right head covering -- a great-fitting wig, a comfortable scarf that you know how to tie, or a stylish hat -- can help you feel a little more "you" and a little less "cancer patient."
Most of the time, says Kelly, women are looking for a wig that will closely resemble their own hair. "They don't want to draw attention to the change, especially in the workplace," she says.
Wigs come in several types: synthetic, 100% human hair, or a blend. True European virgin hair wigs can cost $2,000 or more, while you can buy a synthetic wig for less than $100. Most insurers will pay for a prescribed "cranial prosthesis," but probably not for the priciest of the human-hair styles.
How can you decide what kind of wig is right for you? Each style has advantages and disadvantages, in addition to price. "Synthetic wigs are wash-and-wear, and very easy to maintain," says Kelly. "On the other hand, you don't get the movement that you would with real human hair. Usually, if someone's very visible and is very concerned with people detecting that they're wearing a wig, they'll go with human hair, understanding that the maintenance and cost are a little more than with synthetic."
In addition to wigs, you can also buy several styles of "hat hair." Those are hairpieces that don't cover the whole scalp, but are designed to be worn under a hat, giving you bangs or a ponytail to frame your face. "These too have become a lot more sophisticated," says Kelly. "The hair may be on a headband, so you can switch it with different hats. We're strongly focused on having the patient not look like a cancer patient, so these styles make more of a fashion statement."
Many women end up wearing their wigs out in public, but relaxing in a hat or scarf (or no head covering at all) at home. "Hats can be a big accessory," says McLeod. "You can wear formal, dressy, velvet ones with pins, or wear a baseball cap all day, all summer long. We have everything from solid turbans to ready-wear caps with a short bandanna attached." Most hats for women undergoing chemotherapy are soft, to be gentle on sensitive bare skin, and have drawstrings inside to resize and accommodate wearing with or without a wig.
"I lived in my scarves," says Rubien, a four-year breast cancer survivor herself. There are long scarves you can wrap up, standard squares you can tie in a triangle, and even ready-mades that pop on your head and adjust with a cord. Worried that your scarf will slide off your bald head? Most cancer boutiques sell light "sleep caps" or padded "scarf filler" caps that keep even slippery silk scarves in place.
Breast Cancer Awareness Accessories
And of course, no guide to breast cancer accessories would be complete without a look at awareness accessories. Today, you can literally buy almost anything with the famous pink ribbon on it, from hats and socks to bookmarks, dog collars, and eyeglass cases. But the perennial favorites, says Kelly, are pink ribbon lapel pins and silicone bracelets a la Lance Armstrong, along with baseball caps and sweatshirts. "I do believe that women who've had breast cancer are on a mission for awareness, and rightfully so. And this can be their way of advertising it."