Women who have to battle breast cancer should be treated with dignity and have the same access to care, regardless of whether they can afford it.

This is the opinion of Dr Justus Apffelstaedt of Apffelstaedt, Hoosain & Associates who supports The Ditto Project as part of Breast Cancer Awareness Month.

The project was launched in 2011 and has provided a total of 7 784 silicone prostheses costing more than R5.9m to women who could not afford one.

“The Ditto Project aims to help women regain their self-confidence, giving them access to high-quality silicone breast prostheses and also assist them – through local branches of Reach for Recovery (R4R) – to ensure they choose the correct shape and size for their body,” says R4R chairperson Stephné Jacobs.

“Having a mastectomy leads to a tier of decision making regarding whether to have surgical reconstruction, wear an external breast prosthesis, or not wear anything at all to replace the amputated breast,” says Stephanie van Deventer, the national manager of R4R.

Dr Fatima Hoosain adds: “With a breast cancer diagnosis, there is the possible trauma of the diagnosis, the physiological side-effects of the various treatments (hormone fluctuations, fatigue, nausea and pain), the dramatic changes to your body following mastectomy as well as side effects from radiation and chemotherapy treatments such as weight gain or loss. Some women struggle with a feeling of having ‘lost their wholeness’. All of this can lead to self-esteem issues, and in some cases, even depression. The work that The Ditto Project does is of immense value. Not only from an aesthetic viewpoint, by providing a prosthesis, but from a psychological viewpoint; by providing a sense of wholeness to those who feel a physical loss.”

Carla Lind, the regional chair for R4R Western Cape, and volunteer Michele Coe spearheaded a further project via the Cape Peninsula branch of R4R. “State patients do not have the luxury of shopping at a mastectomy boutique for a proper mastectomy bra after they have received an external breast from the Ditto Project. Many of them do not have access to either the proper bra or the correct size, so vital for supporting the external prosthesis,” says Lind.

“Therefore, in May 2022, the Cape Peninsula branch also started offering a new, subsidised mastectomy bra. This has been a development project in collaboration with Thursdays Lingerie – to provide a locally made mastectomy bra at a price point that was accessible.”

Thursdays Lingerie owner Shona Macdonald says when she spoke to R4R about the Ditto Project, she could understand their mission to help breast cancer survivors feel comfortable in their bodies post-surgery. “This really resonates with my initial reasons for launching Thursdays Lingerie. Designing a bra that can give these women a sense of self pride, allowing them to recognise themselves in the mirror and feel beautiful in public spaces, is so meaningful. Our vocation is to help women see themselves through the kind and loving eyes of their best friend.”

Mastectomy bras

The design of a mastectomy bra is far more complex than that of regular underwear. An internal stretch mesh layer is added to a baseline design that acts as a thin pocket on both breasts. This allows the prosthesis to easily slide in and be kept firmly in place during wear. The pattern grading allows a fit for both smaller and bigger sizes. The bra also features a wide under band (the band that goes under the cups and around the back) that helps the bra to stay in place. The straps on a mastectomy bra are also wider than those on a standard bra. This is more comfortable for most women, especially those who are overweight. For example, wearing a size 12 prosthesis can be very heavy.

Thursdays used their supportive Cape everlasting wireless bralette pattern as a baseline for the mastectomy bra. After consultation with R4R, it was then developed into the Carla mastectomy bra and launched this year.

Mercy Dzemunyasi, a recipient of a R4R prosthesis and a mastectomy bra who recently took part in a photoshoot to help raise awareness for this initiative, says R4R ‘came at the right time’. “I was diagnosed at an early age and it was really shocking. I was both depressed and shattered. When the prosthesis came along, it was a huge change for me. My self-confidence and self-esteem were at an all-time low and this made an enormous difference. When I then got the mastectomy bra, it was an enormous difference. I felt like a whole woman again. The little things make a huge difference when you’re going through something like this. The Ditto Project is literally a lifesaver.”

Apffelstaedt says R4R wants to help women who are dependent on public health services to feel confident again after the traumatic diagnoses and surgery. “We believe that a breast prosthesis is an important step in her recovery, especially for those women from communities where there is still a stigma attached to a cancer diagnosis. A more natural appearance with a breast prosthesis, together with the emotional support that she can continue to receive from Reach for Recovery volunteers through support groups, will help her to return to her normal life.”

Thursdays Lingerie will this month donate 5% of any purchase of the Carla mastectomy bra via their e-commerce site to the Cape Peninsula branch of Reach for Recovery.