FAQs

Glossary
committed to Quality Orthotic, Prosthetic and Pedorthic Care - A Public Service of The American Board for Certification in Orthotics, Prosthetics & Pedorthics

Post-mastectomy Care FAQs

What is a mastectomy fitter?

A mastectomy fitter is a healthcare professional who is specifically educated and trained in the provision of breast prostheses and post-mastectomy services. This includes patient assessment, formulation of a treatment plan, implementation of the treatment plan, follow-up and practice management.

What is an ABC Certified Fitter-mastectomy (CFm)?

An ABC Certified Fitter-mastectomy is a health care professional who has demonstrated knowledge and competence in the field of post-mastectomy care and their qualifications have been tested and accepted by ABC. They are also required to participate in continuing education programs in order to maintain their certification.

What does an ABC Certified Fitter-mastectomy do?

An ABC Certified Fitter-mastectomy evaluates the needs and goals of the post-mastectomy patient in order to determine the appropriate prosthesis, implement a treatment plan, provide follow-up care and coordinate these services with related medical professionals. To provide this care effectively and comprehensively, a mastectomy fitter certified by ABC must have specialized education and skills that enable them to match current and emerging prosthetic techniques and technology to their patients' needs and goals. 

How can patients find an ABC Certified Fitter-mastectomy?

ABC offers a free searchable database of the mastectomy fitters it has certified along with ABC accredited facilities to assist patients in finding a qualified post-mastectomy professional and facility.

When considering a mastectomy fitter's credentials, patients should look for:

  • completion of a pre-certification education course
  • passage of a written examination
  • completion of ongoing continuing education courses

A mastectomy fitter’s certification should always be verified, as this is an indication of qualifications. All mastectomy fitters certified by ABC are bound by its standards of ethics, making them accountable to their patient/client, the physician and the profession.

How can patients find a facility that works best for them?

Picking the right facility is just as important as picking the right mastectomy fitter.

Patients should consider a few questions:

  • Is the facility accredited? ABC operates a stringent accreditation program that indicates that the facility meets strict quality guidelines. Medicare requires that all mastectomy facilities be accredited in order to receive reimbursement. Be sure to check the accreditation status of the facility you choose.
  • Does the mastectomy fitter have experience or additional training working with different types of mastectomy prosthesis? As techniques and technology in post-mastectomy care advance, mastectomy fitters have to keep up with the changes by attending continuing education courses or conferences, make sure the mastectomy fitter you choose is keeping up to date.
  • How convenient is the facility? While this might not be a final factor, patients should know that a good treatment plan will often include multiple visits, so it is helpful to consider a facility’s proximity and office hours.

Before deciding on a mastectomy facility or Certified Fitter, patients should:

  • tour the facility, meet the staff and talk with the mastectomy fitter
  • discuss possible treatment options and get a sense of how the mastectomy fitter will approach their individual situation

What questions should a patient ask the mastectomy fitter?

  • Are you certified in the provision of post mastectomy products and services?
  • Is this facility accredited by a Medicare recognized accrediting body?
  • How long will my first fitting take?
  • Do you have sufficient inventory available to meet my particular needs?
  • What insurances do you take?
  • Will I have any out of pocket expenses?

What types of external breast prosthesis are available?

There are several types of prostheses available depending on your level of mastectomy, your lifestyle and your personal preference.

  • External silicone breast prosthesis: a weighted silicone external breast prosthesis intended to replace surgically removed or altered breast tissue. Breast prostheses restore shape, weight and physiological symmetry. Given that this type of breast prosthesis is weighted, it may help with posture, prevent shoulder drop and improve balance.
  • Non-silicone breast prosthesis: a breast form made from a variety of non-silicone materials.
  • Custom breast prosthesis:  a weighted silicone external breast prosthesis made according to the specific physiological characteristic of each individual. Using CAD/CAM scanning technology or by traditional casting methods, custom prosthesis allow for individual fit and function.
  • Attachable breast form: a self-adhesive breast form that attaches securely to the chest wall. Attachment is maintained by adhesive strips, silicone based adhesion, magnets or other methods. 
  • Camisole with integrated form:  a non-removable breast form that fits into a camisole garment. Post-surgical camisoles are often worn immediately following breast removal or reconstruction surgery or during radiation therapy.
  • Partial, shaper or shell prosthesis: a breast form made of foam, fiberfill or silicone. This type of breast prosthesis is designed to be worn over your own breast tissue to enhance the overall size of the breast and to create a fuller appearance. A partial breast prosthesis can be worn with a regular bra or a post-mastectomy bra.

What is a post-mastectomy bra?

A post-mastectomy bra looks and feels like a traditional bra, but has several very special characteristics that are unique and specific for use after a mastectomy. Manufactured with an integral pocket which holds the external breast prosthesis in place, these garments can be made of lace, cotton, cool wicking fabrics, nylon or microfiber. Straps and bands may be wider, cups are usually fuller to accommodate the external breast prosthesis and the midpoint is higher for support against the chest wall. Mastectomy bras can be purchased at specialty shops or mastectomy boutiques. Some mastectomy boutiques, upon request, will sew special pockets into a traditional bra, swimsuit or nightgown.

How soon after surgery can a patient be fitted for a prosthesis or post-mastectomy bra? 

A non-weighted form can be worn immediately after surgery. Fitting of a weighted external breast prosthesis is dependent on proper healing after surgery. While everyone is different, the typical time frame is six to eight weeks after breast removal surgery, allowing for removal of drains, reduction of post surgical swelling and complete healing of surgical scars.

Where are breast care services provided?

There are many different environments in which post mastectomy services are provided. The most common are post-mastectomy boutiques, a hospital cancer boutique or a prosthetic facility. The primary concern would be to find a comfortable environment at an accredited facility with a mastectomy fitter who is certified.  

Is a prescription required?

Yes, if you are seeking insurance reimbursement.

What should patients wear for a fitting?

Comfortable clothes and a blouse that is easily removed is suggested.  During the fitting, privacy wraps will be provided.

What is the post-mastectomy fitting process?

The Certified Fitter will measure and evaluate the surgical area for pressure marks, scaring and sensitivity. The patient and fitter will discuss all appropriate treatment options including styles, shapes and materials as well as the patient’s goals and expectations. Instructions on use and care of the items will also be provided during the fitting.

Will the prosthesis be noticeable?

While no fit can replace the removed breast, a well fitting external breast prosthesis should be fairly unnoticeable and provide physical and visual symmetry.

What happens if a patient’s body size changes due to weight loss or weight gain?

If there is a change in condition: reduction of swelling, changes in post surgical swelling, torso lymphedema, weight change, additional surgery or any other changes, a reevaluation of the fit of the prosthesis, garments and accessories is necessary.  

 

Better Care = Better Outcomes ©