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Breast Prostheses –What You Need to Know
Tom Baker Cancer CentreSymptom Management│BreastProstheses│TBCC│Rev2012│B0008
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Mastectomy
What is a mastectomy?• Amastectomyissurgicalremovalofthebreastusuallytotreatorpreventbreastcancer.
• Therearefivedifferentkindsofmastectomies:• Subcutaneousmastectomy:removalofentirebreastexceptforthenippleandtheareola(pigmentedareaaroundthenipple).
• Total(orsimple)mastectomy:removaloftheentirebreast;nolymphnoderemoval.
• ModifiedRadicalMastectomy:removaloftheentirebreastincludingthelymphnodesunderthearm.
• RadicalMastectomy:removaloftheentirebreast,lymphnodesunderthearmandthechestwallmuscle.Thistypeofmastectomyisrarelyperformedtoday.
• SegmentalMastectomy:removalofapproximately25%ofthebreast(includingthetumour),andtheremovalofsomelymphnodes.
What are the risks of having a mastectomy?• Mastectomysurgeryisconsideredaverysafesurgery• Somerisksforalltypesofsurgeryinclude:- Bleeding- Infection- Injurytonearbytissues- Somepost-operativepain- Generalanaesthesiarisks
• Possiblerisksassociatedwiththeremovaloflymphnodesinclude:- Shoulderstiffness- Collectionoffluidinthearmpit- Postoperativeswellinginsamearm(lymphedema)- Numbpatchoninsideofarm
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What are my options for replacement of my breast?• Externalbreastprosthesis• Breastreconstruction(internal)–salineorautogenous(forexample,TRAMflap)
What is an external breast prosthesis?• Itisa“fake”breastthatcanbewornagainsttheskin,insideapocketinamastectomybra,orattachedtothechestwall.
• Thereareseveraltypesofexternalbreastprosthesisincluding:- Siliconebreastprosthesis–aweightedprosthesis;madeofsilicone
- Non-siliconebreastprosthesis–light-weight;madeoffoamorfiberfill
- Attachablebreast–self-adhesive;attachesdirectlytochestwall
- Post-surgicalsoftformincamisole–alight-weightbreastformthatfitsintoacamisolegarment;usuallyusedrightaftersurgery
- Partialbreastprosthesis(shaperorshell)–madeoffoam,fibrefill,orsilicone;designedtobewornoveryourownbreasttissuetoenhancesizeandshape;canbewornwitharegularbraorapostmastectomybra
What do I need to know about choosing a prosthesis?• Phoneforanappointment(afittingcantakeuptoanhour)• Takesomeonewithyouwhowillgiveanhonestopiniononthesuitabilityoftheprosthesis
• Wearabrathatfitswell,manywomenprefertheirownbrandofbra
• IfyounormallywearaformfittingT-shirt,blouseorsweater,besuretotakeonealongwithyou
• Onceyouhavechosenaprosthesis,youmayfindthatitseemsheavy.Wearitforafewhourseachdaytoallowyourbodytoadjusttotheweight
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What is a post mastectomy bra?• Itlookslikearegularbraexceptthatishasstretchypocketsinsidetoholdabreastprosthesis
How soon after a mastectomy can I wear a prosthesis?• Thistimelineisdifferentforeveryoneandthereforemustbediscussedwithyoursurgeon
Will others be able to tell that I am wearing a breast prosthesis?• Noonewillbeabletotellaslongasyourprosthesisfitsproperly
Do I need a prescription for a breast prosthesis and mastectomy bra?• Youwillrequireaprescriptionforinsurancepurposesonly
Will my breast prosthesis and mastectomy bra be covered by insurance?• BreastprosthesesarecoveredthroughAlbertaAidstoDailyLiving(AADL).Pleaseseepage7forfurtherinformationregardingcosts
• Mastectomysuppliesmaybecoveredthroughyour3rdpartyinsuranceplan.Pleasecallyourinsurancecompanytodetermineyourspecificcoverage
Where can I get breast prostheses and other mastec-tomy supplies?• PleaseseeanattachedlistofapprovedAADLvendorsinCalgary
What is breast reconstruction?• Breastreconstructioninasurgicalprocedurethatgivesyouabreastmoundfollowingamastectomy.
• Thereareseveraltypesofbreastreconstructionwhichcanbe
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reducedtothesetwomaincategories:• Artificialimplants• Reconstructionusingthewoman’sownbodytissues
Who should have breast reconstruction done?• Thisisapersonalchoice.Therearenomedicalreasonsforhavingbreastreconstruction,butmanywomenexpresssomepsychologicalbenefit
When should I have breast reconstruction?• Breastreconstructioncantakeplaceatthesametimeasyourmastectomysurgery,oritcanbedoneatanytimeinthefuture
• Discussthebestoptionforyouwithyourphysician
Sources: www.nlm.nih.gov/medlinepluswww.ucsfbreastcarecenter.orgwww.surgery.uiowa.edu/surgery/plastic/brecon.htmlwww.baptistoneword.org/healthinfo
Where can I receive emotional support?
Counselling and Support Department of Psychosocial Resources Tom Baker Cancer Centre• Phone403-355-3207• Counsellingandsupportforyou,yourfamilyandfriendsisavailablefreeofchargeattheDepartmentofPsychosocialResourcesattheHolyCrossSite
• Thisdepartmentisstaffedbyprofessionalcounsellors(psychologistsandsocialworkers)thatarespeciallytrainedtohelpyouandyourfamilycopewiththeemotional,psychologicalandsocialstresseswhichoftensurfaceasaresultofcanceranditstreatment
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New Breast Cancer Patient Groups• Forwomenwithintheirfirstyearafterdiagnosisofbreastcancer• ForwomenwithStage1-3breastcancer• Eachsessionsconsistsof12weeklymeetings• Thereare3sessionsperyear• Pleasecall403-355-3207formoreinformationandtosignupforthisgroup
Group for Women with Metastatic Breast Cancer• Pleasecall403-355-3207formoreinformationaboutsigningupforthisgroup
• Ongoingweeklymeetings–Tuesdaysat1:30pminthePsychosocialDepartmentattheTomBakerCancerCentre
• Pleasecall403-355-3207tobookanappointment
Wellspring• Pleasecall403-521-5292• Formoreinformationgotowww.wellspringcalgary.ca• Providesongoingsupportprogramsandservicesforindividualslivingwithcancer
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Cancer Connection
• Telephonebasedprogramthatofferspeersupportdesignedtoputyouand/oryourcaregiverintouchwithsomeonewhohasalreadybeenthroughwhatyouarefacing.
• Trainedvolunteerswilllisten,provideemotionalsupport,andsharepracticalinformationaboutlivingwithcancer
• Foradultsatanypointintheircancerexperience,andtheircaregivers
• CancerConnectionisafreeserviceavailablethroughoutAlbertaandtheNorthwestTerritories-MondaytoFriday8:30am-4:30pm
• One-on-one,inpersonvisits,orpeersupportgroupscanalsobeaccessedbycalling1-888-939-3333andpress#2totalktoasupportspecialist.
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AADL Mastectomy Benefits
What is it?• AlbertaAidstoDailyLiving(AADL)assistAlbertansbyprovidingfinancialassistanceformastectomyprosthesis(fullorpartial)forwomenundertheageof65thatarearesidentofAlbertaandhaveavalidAlbertaPersonalHealthNumber(PHN)
Are mastectomy supplies covered?• Yes,onemastectomyprosthesisperbreast**iscoveredthroughAlbertaAidstoDailyLivingevery3years
**Provide100%coveragethroughAlbertaBlueCrossforSeniorsProgramforpeopleage65yearsandoverbasedonAADL’scurrentpricing.ClientsmustuseanapprovedAADLvendortoobtaintheirbreastprosthesis.
How much will it cost?• AADLhasacostsharingpolicy,whichrequirestheclienttopay25%ofthecost(s)ofthebenefit(s)toamaximumcontributionof$500perfamilyperbenefityear(July1throughJune30)
• AADLwillpayfor75%ofabreastprosthesisatAADL’scurrentbenchmarkprice(subjecttochangeatanytime)andafittingfeeforeachprosthesis
• AADLapprovedmastectomyvendorshavecontractualobligationstoprovidequalityproductsatorbelowAADL’sbenchmarkprice
• Inaddition,youhaveachoicetopickaprosthesisthatcostsmorethanAADL’sbenchmarkprice,howeveryouwillberesponsiblefor100%oftheamountovertheAADLbenchmarkprice,notincludingyourcostshareportion.
• Forexample,ifAADLbenchmarkpricewas$316- AADLwillpay$237(75%of$316)oftheprosthesis- AADLwillpay$22.50(75%of$30)ofthefittingfee- Youwillpay$79(25%of$316)- Youwillpay$7.50(25%of30%)- Yourtotalcostis$86.50
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• IfyouhaveAlbertaBlueCrossNon-Groupcoverage,youwillbecoveredfortheremaining25%ofcoststhatareabovetheallowablecoverage
• Ifyouhaveother3rdpartyinsurance,pleasecontactthemtoinquireaboutyourcoverageformastectomyprostheses
• Pleasebeawarethatifyouaregoingtouseyour3rdpartyinsuranceandAADL,AADLmustpayfirst,followedbyyour3rdpartyinsurance.IfyoudonotwanttoaccessAADLforyourprosthesis,thisisyourchoice,butpleaseensurethatyourinsurancecompanywillcoverallcostspriortoobtainingtheprosthesis,asAADLisnotareimbursementprogram
• Senior’sBlueCrossprovides100%coverageofabenchmarkprice
What is the next step?• MakeanappointmentattheCADLorspeakwithyourcommunityorhomeCareNurse
• IfyouhavequestionsregardingtheAADLProgramordonotknowhowtoaccesstheAADLProgram,pleasecalltollfreeat403-310-0000thendial780-427-0731
• AADLwillprovideyouwithalistofvendorswhereprosthesesaresold
• Pleaseconsiderbookinganappointmentwiththeprosthesisfitter
How do I contact them?
Calgary Aids to Daily Living (CADL)4020BownessRoadNWCalgary,AlbertaPhone:403-955-6955Fax:403-943-2110Hours:8:00am–4:30pmMon-Fri
• ForuptodateinformationonapprovedAADLvendors,pleasevisitwww.health.alberta.ca/services/aids-to-daily-living.html.ClickontheProgram Manuallink,scrolldowntotheMastectomy ProsthesessectionheadingandclickontheApproved Product ListlinktodownloadaPDFlisting
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Calgary:
AADL Authorized Mastectomy Prosthesis VendorsPleaserefertoyourlocalyellowpagesdirectoryforacompletelistingofvendors.
• AbilityMedicalSuppliesLtd3439–26thAveNE403-263-9994
• CalgaryCo-OpHomeHealthCare9309MacleodTrailSW403-263-9994
• CalgaryCo-OpHomeHealthCare4938RichmondRoadSW403-299-4488
• CompassionateBeauty26,22RichardWaySW403-686-6936
• KenronPharmacy100,1620–29thStNW403-289-7224
• ShoppersHomeHealthCare25A-180,94AveSE403-255-2288
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Lethbridge:
AADL Authorized Mastectomy Prosthesis VendorsPleaserefertoyourlocalyellowpagesdirectoryforacompletelistingofvendors.
• Leister’sHomeCare1224–3rdAveS403-380-2600
• ShoppersHomeHealthCare102,2045MayorMagrathDrS403-328-5599
• ShoppersHomeHealthCare119StaffordDriveS403-327-4511
• StaffordPharmacy&HomeHealthcare1475StEdwardBlvdN403-320-6500
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Medicine Hat:
AADL Authorized Mastectomy Prosthesis VendorsPleaserefertoyourlocalyellowpagesdirectoryforacompletelistingofvendors.
• CrestwoodPharmacyLtd1827DunmoreRoadSE403-527-4990
• ShoppersHomeHealthCare2,46CarryDriveSE403-527-8110
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Red Deer
AADL Authorized Mastectomy Prosthesis VendorsPleaserefertoyourlocalyellowpagesdirectoryforacompletelistingofvendors.• MillerdalePharmacyLtd5201–43Street403-342-1434
• ShoppersHomeHealthCare70C,5250–22Street800-307-6997
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