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| Patricia Metcalf, Orthotist/CMF, A Fitting Image, demonstrates placement of a breast form in a swimsuit to Mildred Holtz, mastectomy patient. |
Every three minutes a case of breast cancer is
diagnosed; every 13 minutes a woman dies from the  disease.
The good news is that breast cancer-if diagnosed
early-is highly treatable. Over two million breast cancer
survivors are alive in the US, and many of them are receiving
post-mastectomy fitting of forms and prostheses from O&P
facilities. Here are just a few of the O&P companies involved
in post-mastectomy care.
A Fitting Image is a small, separate boutique
under the aegis of Calumet Orthopedic and Prosthetic Co., Hobart,
Indiana. “Since these survivors have gone through a very traumatic
situation, we want to make them feel as comfortable as possible,”
said Micki Pawlowski, Calumet vice president.
An attractively decorated separate room for fitting
post-mastectomy patients and women patients requiring corset and
spinal bracing features a soothing feminine ambience. Patty
Metcalf, a certified mastectomy fitter and orthotist, educates
clients by showing a video of breast forms and how they are
created, and by answering questions. Patty’s warmth and concern for
her clients gives them a big psychological boost.
“Since we are an O&P facility, I have the luxury of offering
breast cancer survivors a wide selection of prostheses and bras
instead of ‘whatever is in stock,’ said Alison Kimura, CO,
CMF, Total Care, Clifton Heights, Pennsylvania.
“Our office offers mastectomy products ranging from prostheses and
bras to camisoles and swimwear. I feel that having these choices is
an important and necessary service for these women.” Due to space
restrictions, the facility uses a regular patient care room rather
than a separate area. The company is included in the local chapter
of the American Cancer Society’s provider list, Kimura added.
Boland Prosthetic and Orthotic Center, Warner
Robins, Georgia, offers post-mastectomy services ranging from
compression sleeves to a full breast prosthesis line, according to
Stephanie Molnar, CMF. “Our services not only include fitting, but
also consultation and reassurance after the fitting has been
completed, because we understand that this is a new experience for
many of these women. They need to know that someone is there for
them.”
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| Stephanie Molnar, Boland O&P |
She added, “I extend not only my expertise in being a certified post-mastectomy fitter, but also the patience to sit and listen, when this may be all these ladies need.”
The facility has a special room set aside to provide a secluded, warm environment for fitting. All the products are kept in the room during the fitting process to minimize traffic in and out of the room. “This helps show the patient that we are setting aside this time for them, and that we are focused on providing the best
services and products available,” Molnar said.
In 1996 Britt M.G. Aguilar, CPO, helped create the
Breast Care Center in Loma Linda, California, with
the support of the Loma Linda University Cancer Institute, Loma
Linda University Medical Center. The Institute also established its
Breast Cancer Division in 1996, under director Carlos Garberoglio,
MD, who also is one of the surgeons. The comprehensive services
include pre-surgery consultation, follow-up, and provision of
post-surgery custom prostheses. A private room is specially
decorated to help patients feel comfortable during consultations
and fittings. Bras and prostheses are designed for patients who
have undergone mastectomies, lumpectomies, or edema, scar, and burn
management.
The centers’ brochure notes that most insurance plans follow
Medicare guidelines, which include allowing two post-mastectomy
bras every year and one prosthesis every two years. However, the
center recommends that patients contact their insurance companies
or third-party payers to determine coverage and needed
authorization before scheduling an appointment.
Aguilar strongly feels that improvement in breast care services
is needed throughout the country. A large need is for increased
patient education, both pre- and post-surgery, she said. Better
fitting of breast prostheses and bras and achievement of longer
term patient satisfaction both physically and psychologically is
another vital area, she added.
Artisan Orthotic Prosthetic Technologies,
Tualatin, Oregon, has been in business for just over a year. The
facility currently provides only off-the-shelf forms and
prostheses. “We are not sure there is a huge call for custom breast
prostheses,” said Terri Wells, CMF. “At least, at this point we are
not ready to incur the additional costs needed to provide custom
forms.”
Although she has not had time to do much marketing, Wells notes
that she has been successful with previous patients following her
to the new facility and with word-of-mouth advertising. She also
receives quite a few referrals from a physical therapist who
specializes in lymphedema, a mastectomy complication in which lymph
fluid flow is obstructed, resulting in pain, swelling, and
increased susceptibility to infection. “My goal is to have the
mastectomy portion of our business more profitable within the next
three years,” Wells added.
Mahnke’s Orthotics & Prosthetics, Fort
Lauderdale, Florida, provides both custom and off-the-shelf breast
forms and prostheses, fitted by certified mastectomy fitters,
according to Jim Newberry, LPO. However, he has found that
third-party insurers often consider these services
non-reimbursable.
Riverside Prosthetics, Evansville, Indiana,
provides post-mastectomy services with two certified fitters, Cindy
Whitehurst and Stephanie Willis. “We do not see much need to
provide custom-made forms, since custom-fit is suitable,” noted
Whitehurst.
J.J. Hill Brace and Limb Company, Gulfport,
Mississippi, not only provides breast forms and bras, but also
custom and off-the-shelf lymphedema sleeves and vests, turbans,
bathing suits, sports bras, and nightgowns, according to Dawn Hill,
BOCO, CPed, CMF. Three certified mastectomy fitters care for
clients, who are fitted in a separate fitting room. Two of the
fitters are also orthotists.
The company also holds open houses with bathing suit sales and
information for pre-mastectomy patients. “We pride ourselves on
being able to give the biggest selection of mastectomy products on
the Mississippi gulf coast to ensure the patient’s happiness with
the products they receive,” Hill said. J.J. Hill Brace and Limb is
included in the American Cancer Society’s post-mastectomy product
provider list.
Obtaining and maintaining certification is very important, Hill
noted. “We think certification helps assure our patients…that
we are professionals.”
Breast Cancer: A Statistical Snapshot
A total of 203,500 new cases of breast cancer are expected to be
diagnosed in 2002, and 39,600 women are expected to die, according
to the National Alliance of Breast Cancer Organizations (NABCO).
Based on current life expectancy, one in every nine women will
develop the disease; in 1960 the ratio was one in 14. Men too can
develop breast cancer, although it is relatively rare. In 2002,
1,500 male cases are projected to be diagnosed; 400 men are
expected to die.
October is Breast Cancer Awareness Month. For more information
about breast cancer and Awareness Month activities, visit the NABCO
website: www.nabco.org, and the National Breast Cancer
Awareness Month site: www.nbcam.org
