Agency Helps Mastectomy Patients Cope With Loss

NEW YORK--The woman shyly lifted her sweater, and in halting Englishapologized for her old brassiere. The left cup was stuffed witha towel where her breast used to be. She had come to Cancer Care,Inc. in Manhattan for help.

A breast prosthesis costs about $250. In many states, Medicaidand Medicare pay for prostheses and bras, but patients are notalways told that, and this lady had been walking around for 4years with a towel in her bra.

But in a few minutes she would be smiling and standing tallerlooking at herself in the mirror. Wearing a new red satin "Rendezvous"Maidenform bra, the color lovely against her caramel skin, theleft cup filled with a new pink 36B breast prosthesis, she wastransformed.

Once a month, women come to Cancer Care's New York office forthe "All You Want to Know About Breast Prostheses" clinic,given by Carol Art Keane, owner of Underneath It All, a post-breastsurgery boutique in Manhattan. Ms. Keane herself had a mastectomy4 years ago, and started the business when she realized how fewstores carry products for women who have had mastectomies.

At Cancer Care, Ms. Keane alters and fits bras, and gives awaybras and prostheses to poor women who are not covered by Medicaidor Medicare. She also helps those who are eligible to apply fortheir Medicaid or Medicare allowance for these items.

Every big bra manufacturer in New York City--Maidenform, Playtex,Lovable--donates to the program, she said. They give "beautifullingerie, not irregulars, often with panties to match." Equallypretty surgical bras--bras with cups for the prostheses--are donatedto Cancer Care by Coloplast/Amoena and Natural Wear by Camp.

Fitting the bras and prostheses, which have a polyurethane exteriorand silicone interior, Ms. Keane works like a couturier. "Lookspretty good. It's just a little more projection than I would like,"she said, stepping back to assess a fitting.

The fitting of a bra with a prosthesis is a complicated procedure."You are trying to match the prosthesis to the natural breast.Fitting a bilateral mastectomy is much easier," she noted.The average size prosthesis, a 34B or C, weighs about a poundand feels much heavier in the hands. Polyurethane-covered siliconeshells are also available, to make a reconstructed breast appearlarger when it fails to match the existing breast, or to covera natural breast so that it more closely matches the reconstructedone.

In New York State, Ms. Keane said, Medicaid covers two prosthesesand eight bras a year, while Medicare provides one prosthesis,one lightweight leisure prosthesis, and four surgical bras a year.It makes her angry, she said, that many hospitals do not takethe time to tell patients that these items are due to them.

From Despair to Smiles

As Ms. Keane did the fittings, Elaine Baron, a Cancer Care volunteerand survivor, scurried about the conference room, ushering inthe women, offering coffee, and making each shy lady feel a bitbetter--for despair can erupt easily in this little room.

One woman who had somehow managed to avoid looking at her postmas-tectomychest at home was suddenly confronted with her image in the mirror,and she cried. "Don't cry, Mommela," pleaded Ms. Baron,and for just a moment everyone in the room was weeping.

But then it was back to the task at hand. Out came a dainty blueChantilly lace bra. It looked fabulous on the lady at the mirror,and she smiled.