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Last Updated: Sunday, 12 March 2006, 02:10 GMT
'I lost my breast and my confidence'
By Jane Elliott
BBC News health reporter

Using a prosthesis
A prosthesis can fit into the bra

Jan Hodson is a woman brimming with confidence and is happy with her body.

She loves pretty underwear, and used to be a fitter at her local store - even being a special model for bra-makers Triumph.

Fourteen years ago though, things were very different. Doctors had diagnosed her with breast cancer. She had a lumpectomy and then needed a mastectomy and was put on a course of tamoxifen.

Her confidence slumped and she became very depressed. Her surgeon told her that he did not recommend reconstructive surgery for two years, until patients were in a suitable mental state to make rational decisions.

Devastated

She was devastated and felt that, along with the breast, the cancer had taken part of her femininity, her confidence and her happiness.

A brusque breast cancer nurse gave Jan, from Wolverhampton, a prosthesis, but it did not fit properly and her confidence slumped even further.

In the dark days after I was diagnosed, I never though I would have had such a wonderful time ahead of me
Jan Hodson

"I was shell-shocked after the cancer diagnosis," she said.

"Your body just does not know what is happening. You feel as if you have lost your femininity.

"The breast cancer nurse just gave me something to put in my bra. She just told me to put it in and that was it. She then called my husband into the fitting room and told him not to cosset me.

"I wore that prosthesis for two years. It did not fit properly and used to rub me and I had blisters, because I have very protruding ribs. I had a line of blisters where the bra was.

"After two years I decided not to have any more surgery. I thought I would not put myself through that. I wasn't happy with the decision, but I knew I did not want any more surgery.

"My confidence had hit rock bottom. I really did not think I could live my life like that. I was devastated - it really was an awful time."

'Changed woman'

But having made her decision not to have further surgery, Jan, now aged 62, decided she needed another prosthesis fitting. This time, however, her experience was totally different.

She saw a different nurse, and was offered a choice of prostheses. The nurse carefully helped her select the one she felt happiest with and Jan says she left the fitting feeling like "a changed woman".

Filled with new confidence, she decided to apply for a job in her local department store and was asked if she would work as an underwear consultant.

Jan Hodson
Jan found a new lease of life

She arranged for a breast care nurse to come into the store and talk about prosthesis to customers, and she offered herself as a model for bra firms so they could acquaint themselves with what it was like to fit a woman who had a mastectomy.

She even modelled in a number of fashion shows.

"In the dark days after I was diagnosed, I never thought I would have had such a wonderful time ahead of me.

"I just want to say to other ladies who are diagnosed that you do go down a very dark tunnel at first and things do look very bleak, but there is a bright light waiting for you at the end of that tunnel.

"You do get a chance to make something out of your life."

Guidance

Worried that women like Jan are having such bad experiences, the charity Breast Cancer Care has produced the first care standards for breast prosthesis-fitting.

Backed by the Royal College of Nursing, the guidelines - "A confident choice" - have "top 10" tips for best practice, patient stories, facts, figures and illustrations.

Helen Brahmbhatt, an information nurse at Breast Cancer Care, said women deserved the best possible choice available and that she hoped the guidelines would help ensure that.

"We have done some research and found that women are not always happy with their fittings."

Their studies found that some women were not being offered prosthesis that matched their skin tone, that some were too big or small and that some of the fittings were even being done by men, which left some women uncomfortable.

Helen said: "There has been a problem with some of the black and Asian women being offered prostheses that do not match their skin tones. It could be devastating if you were black and were offered a pink prosthesis."

Breast care nurse Liz Hopkins, a specialist in the field for 15 years at the Queen Elizabeth Hospital in Birmingham, added that the new standards should help to change views.

"Breast prosthesis-fitting has come a long way in recent years and we are proud of the service we provide here, but it can be a struggle to get the recognition it should have.

"I'm already finding these standards invaluable though in my everyday work. They really help me and my team to defend our service and promote its importance."




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