Group helps cope with breast cancer
by Bismarck Tribune Sara Kincaid
Posted on 11/19/2009
Paulette Neff reaches under her blouse and pulls something out of her bra.
The triangular object is malleable, and warm from laying against her skin. It’s a type of prosthesis she uses to create symmetry between her breasts that was lost almost six years ago when she had a lumpectomy to remove a tumor in her right breast.
“It’s just like getting dressed or putting on a pair of earrings,” Neff said about using the prosthesis.
About 250,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society. For most women, a breast cancer diagnosis results in partial or complete removal of one or both breasts. What is done is dependent on the size of the tumor, the stage of the cancer and the patient’s preference.
Neff chose to go with a lumpectomy over a mastectomy. The surgery removed a portion of the underside of her right breast, retaining the rest of her breast.
She was diagnosed in 2004. After her surgery, she had chemotherapy and radiation treatment at the Bismarck Cancer Center. “I dreaded hearing that six-letter ‘C’ word,” she said. “I was scared and didn’t know what to expect.”
Over the years, she’s reached acceptance with the changes breast cancer made in her body. It can take time for women to come to terms with the physical changes caused by surgery. For Neff, she accommodates the changes in her body with the prosthesis.
“At first, I didn’t think I needed it because mine is at the six o’clock position,” Neff said. “I didn’t like the way I looked in the mirror.”
In Bismarck, there is a support group for women who have had mastectomies. The support group meets the third Thursday of the month at Great Plains Rehabilitation Center.
Many of the women in the support group are in their 50s, Neff said, but there are women who are younger and going through treatment for breast cancer. “I wish more would come,” she said.
Every member of the group gets a phone list of other members. Notes next to some of the people explain the type of surgery they had done. This lets women contact other women who have gone through something similar.
The support group started 20 years ago. Joyce LaChapelle has been a part of the group for 19 years. About five to 15 women show up at any given meeting. LaChapelle visits women in the hospital to let them know about the support group, as well as other services that are available to them.
Usually a guest speaker comes to the meeting, and women have a chance to ask questions about that evening’s topic. The speakers can include plastic surgeons, oncologists, representatives from the local American Cancer Society chapter and people who can explain the insurance process. The speaker talks for about 20 minutes or so, then the meeting is open to questions.
Some women elect to have reconstructive surgery after a mastectomy, while other women opt to wear prostheses. Insurance pays for the prostheses and bras that have special pockets to keep the prostheses from falling out.
Great Plains sells prostheses, and has a special fitting area to help find the proper fit and size. Inside the wardrobe in one of the fitting rooms, there are boxes of prosthetics and a variety of bras. “They like looking nice,” said LaChapelle, a clinical assistant at Great Plains Rehabilitation. “You see them look in the mirror and see tears starting.”
With the advent of genetic testing for a breast cancer gene, more women are electing to have a mastectomy without having signs of cancer. For women who test positive for one of these genes, or have a family history of breast cancer, an elective mastectomy can result in a 90 percent decrease in the woman’s risk for breast cancer, according to the American Cancer Society. About 5 percent to 10 percent of breast cancer cases are because of an inherited risk or a genetic mutation. Less than 1 percent of women are expected to have a genetic mutation, according to the American Cancer Society.
Neff is thinking of being tested for the BRCA genes after discovering her insurance provider would cover the cost of the test. There are two genes, the BRCA1 and the BRCA2 that can indicate an increased risk of breast cancer. She’s concerned about the implications of getting the test done. For one thing, it would mean a bilateral mastectomy, which would remove both breasts. But then she also worries if she would be eligible for insurance coverage if she tested positive and her insurance provider changed in the future.
Breast cancer is the seventh leading cause of death in women in the United States, according to the Centers for Disease Control and Prevention. The disease is usually detected through mammography.
Recently, the United States Preventive Services Taskforce evaluated recommendations for breast cancer screenings, and decided to recommend against breast self-exams. This advice falls in line with most organizations that provide screening recommendations, except for the American Medical Association, which recommends women perform self-exams.
Women interested in attending the support group can come to Great Plains Rehab on the third thursday of the month. The meeting can be accessed by entering the door on the east side of the building and going upstairs. The meeting starts at 7 p.m.