Manufacturers of post-mastectomy products and breastfeeding supplies have raised the bar this year by improving comfort, durability and efficiency all
by Denise H. McClinton

Manufacturers of post-mastectomy products and breastfeeding
supplies have raised the bar this year by improving comfort,
durability and efficiency — all key aspects of women's health
care products. The measure of success for providers, however, is
their willingness to serve this customer base with individualized
attention, service and sensitivity.

Although reconstruction following breast cancer surgery is on
the rise, longer survival rates and breast-conserving surgeries
have created a strong demand for new products, says Larry Knudsen,
vice president of sales for CAMP Healthcare.

“The overall market for breast prostheses has remained
relatively stable during the last couple of years,” he says.
“With the advent of new surgical techniques for breast
cancer, there has been a decline in the number of new mastectomy
clients that require an external prosthesis; however, the breast
cancer survivor is living longer post-surgery, and as a result
there is continuing demand for external prostheses. In addition,
breast-conserving surgical procedures create a demand for new types
of products that deal with individual post-surgical

Not Necessarily New But Definitely Improved

Although manufacturers have not revamped the process for
building a better breast form — silicone is the best choice
for breast prostheses — they are going to great lengths to
improve the end product.

Light, cool and comfortable are the optimal goals for breast
forms, says Christine Voet, product manager for Airway, a division
of Surgical Appliance Industries. Airway's newest products
incorporate a microfiber backing that is designed to wick
perspiration away from the skin.

Amoena has also focused on comfort in its latest generation of
products. “We are using the newest technology of lightweight
silicone to come up with such forms that are attractive to a
considerably large population of the women,” says David
Simic, the company's vice president and general manager. “We
offer one- and two-layer breast forms, contact breast forms and a
line that incorporates a soft gel back.”

CAMP Healthcare's Radiant Impressions breast form is a custom
breast prosthesis that is actually hand-crafted from a body cast
impression, says Nikki Giamarino, CAMP's breast care product

“The process creates an amazingly lightweight form, and
the silicone foam matrix that forms the interior core of the
Radiant Impressions form gives it the ‘breathable’
feature,” she explains. “Likewise, the custom breast
prosthesis is ideal for the survivor that has a difficult-to-fit
surgical site, cannot tolerate available non-custom products or
requires the non-surgical breast reconstruction

CAMP also offers non-custom breast prostheses that are
significantly lighter than the forms of just a few years ago.

Judi Simon, president of Capital Marketing Technologies, says
like other manufacturers, her company has a lightweight breast
form, which is appropriate for younger women who are being
diagnosed and treated for breast cancer earlier than in the past as
well as long-term survivors whose bodies cannot support the heavier
forms they have been accustomed to wearing.

And, breast forms are not just getting lighter; they are
becoming easier to use and maintain. Bragel's new Li'a Essence line
of breast forms features a skin-friendly adhesive that is strong
enough to hold the breast form in place without a bra, says David
Chan, Bragel's vice president of operations. The forms also are
washable with ordinary soap and water.

Another trend developing in the post-mastectomy products market
is the interest in partial breast forms, which are also called
enhancers or equalizers. These forms are appropriate for women who
choose a lumpectomy, for women with hyperplasia, and for women who
still need additional support following reconstruction.

Ancillary products, such as post-mastectomy camisoles and
loungewear, are becoming more popular as consumers become more
vocal about their needs.

“Women are wanting more, and that's why we address the
lingerie,” says Linda Jackson, president of Ladies' First.
“We try to do the things that no one else wants to do. Women
say ‘There are a million [breast] prostheses and a million
bras, but what about other products like lingerie?’

“Newly diagnosed women and women who were diagnosed in the
past and who are surviving now — because these women are
educated — want more choices, and we try to provide

Creating Opportunity

In many communities, both traditional HME providers and
specialty women's boutiques offer breast forms, post-mastectomy
lingerie and related products. Fortunately, experts say, there is
opportunity for both when customer service and satisfaction are
strongly supported.

Simic sees benefits in both. “Many of the boutiques are
owned by ladies who are actually survivors themselves and have a
very strong feeling and understanding of what a new user would be
going through,” he says. “On the other hand, in an HME
store, there are clinical people who understand the needs of the
patients. I think they can get equivalent levels of care in either
of those locations.”

Regardless of business type, women's health providers' marketing
methods will make a strong difference, according to Simon. She
suggests providers employ the following strategies to inform their

  • Make your local American Cancer Society office aware of your
  • Place brochures in surgeons' offices
  • Contact churches and women's groups
  • Advertise that you do breast form fittings in your Yellow Pages
    and newspaper ads

Voet adds that it is critical to make a complete assessment of
the woman's physical, emotional and recreational needs and to
ensure she is aware of all of her options.

“It's hard to assess someone's lifestyle — some
people are far more active than others who are sedentary and have
limitations. Some just want something that is cool and comfortable,
and others love fancier, lacy products,” she says. “You
really have to get to know each customer.”

Knudsen agrees. “It is important for the provider to offer
an environment that is inviting and comfortable for the survivor as
well as a variety of options to meet a woman's unique
requirements,” he says. “A provider that offers these
benefits and values customer service will have ample opportunity to
be successful in the post-mastectomy market.”

With innovation less common in the women's health market than in
other HME markets, service is what makes providers, and even
manufacturers, stand out from another.

“Generally speaking, all manufacturers [of women's health
products] stay in touch with their customers — the fitters
— and hear from them what their customers — the end
users — are asking for,” Jackson says. “Store
owners are leaning more towards providing customer service than
providing innovative products.”

Every survivor and every surgery are not the same, which means
service should be determined on a case-by-case basis.

“Every lumpectomy is different and every mastectomy is
different, so you don't how much scar tissue is left,” Voet
says. “That's why it's such an individual service-oriented

The Mommy Market

Breastfeeding is once again “in vogue.” National
campaigns, obstetrician and pediatrician recommendations and
clinical evidence of how breastfeeding can benefit children are all
influencing the rising numbers of women who choose to breastfeed.
This is good news for providers who choose to rent or sell breast
pumps and accessories.

“Breastfeeding in general is on the rise — it's
become fashionable,” says Mary Van Scheltema, Medela's
director of marketing communications. “Additionally,
government dollars are going toward campaigns to increase both the
number of people breastfeeding as well as to lengthen the

To encourage women to continue breastfeeding — the
American Academy of Pediatricians recommends breastfeeding for the
first year of life — manufacturers have worked towards making
breast pumps more efficient and comfortable.

The pumping experience can be pretty intimidating, says Van
Scheltema. “Before they have a baby, most women have no idea
how pumping works or if they will be able to do it — there's
a lot of fear and uncertainty among new moms,” she explains.
“Medela wanted to develop a full line of pumps that would
take the fear out of pumping and make it as comfortable and as
close to nursing their baby as possible.”

One of Medela's most recent enhancements is designed to mimic a
baby's nursing rhythm. Its new Pump In Style Advanced personal use
breast pump features Natural Expression technology. First
researched and developed for hospital breast pumps, Natural
Expression is an advanced pumping pattern that mimics babies'
nursing rhythms by pumping in two distinct modes.

“Babies actually nurse in two rhythms. At first, it is a
very fast, shallow suckling to get the milk to let down, and then
once the milk begins to flow, babies shift to a much slower,
stronger suction,” says Van Scheltema. “So, we have
created a pump that mimics babies' nursing rhythms by pumping in
two distinct modes.”

Medela has also incorporated the Natural Expression technology
into its hospital-grade breast pump, the Symphony, and its Harmony
manual pump.

CAMP Healthcare is offering a new design that improves the
effectiveness of its breast pump. CAMP's Expressly Yours Soft-Cup
funnel design triggers prolactin, the milk making hormone,
resulting in increased milk flow for the nursing mother, according
to Knudsen.

“It actually functions like a nursing baby by contouring
to the shape of the breast and matching the natural suckling motion
of the baby,” he says.

The best way to market breastfeeding supplies is through
referral sources, say experts. Contacting the appropriate local
physician groups and clinics and providing them with brochures for
their waiting room that describe the products and services you
offer for an expectant mother is also an effective approach when
coupled with contact with lactation consultants.

“The referral source is a key to success for the HME
provider carrying breastfeeding products,” Knudsen insists.
“Getting to know the lactation consultants in your area
hospitals and making them aware of the products and services you
offer is integral to your marketing program in this

Whether serving the women during illness or pregnancy, it pays
to ensure their satisfaction. They will become referral sources in
the community, in their families or for themselves as they age or
encounter other health care conditions.

Experts Interviewed:

Greg Biddulph, marketing manager, Juzo USA, Cuyahoga Falls,
Ohio; Nikki Giamarino, breast care product manager, and Larry
Knudsen, vice president of sales, CAMP Healthcare, Jackson, Mich.;
Linda Jackson, president, Ladies' First, Salem, Ore.; Tim
Pennington, national sales manager, Truform, a division of Surgical
Appliance Industries, Cincinnati; Mimi San Pedro, vice president of
sales and marketing, ContourMed, Little Rock, Ark.; David Simic,
vice president and general manager, Amoena, Marietta, Ga.; Judi
Simon, president of Capital Marketing Technologies, Waco, Texas;
Mary Van Scheltema, director of marketing communications, Medela,
McHenry, Ill.; Christine Voet, product manager, Airway, a division
of Surgical Appliance Industries, Cincinnati.

Getting the Word Out

Post-mastectomy products, like many other home medical equipment
items, go mostly unknown until a need for them arises, which makes
marketing challenging. Fortunately, HME providers can appeal to
certain referral sources that have the ability to communicate with
many breast cancer survivors regarding available options.

One such group is the American Cancer Society's Reach to
Recovery support network. Reach to Recovery volunteers are
specially trained to provide support to patients when they first
receive a diagnosis of breast cancer. In addition to emotional
support, volunteers are also able to inform survivors about their
options. Although volunteers do not endorse any particular product,
they can provide information on what is available.

The Inspirations of Hope calendar, offered by Amoena,
gives providers a tool that can assist them in promoting breast
cancer awareness and marketing their products and services.
According to David Simic, vice president and general manager of
Amoena, it is an excellent tool for providers to align themselves
with a good cause, gain visibility in the community and attract
more people into the store.

The calendar, which features artwork from breast cancer
survivors, will go on sale in October at participating Amoena
retailers in honor of National Breast Cancer Awareness Month. Net
proceeds from calendar sales will be donated to Y-ME National
Breast Cancer Organization on behalf of all participating Amoena

Marketing to Women

The women's health care segment of the home medical equipment
industry is not only profitable, but it is growing as well. For
many HME providers, the key will be acquiring and retaining women
customers at all stages of life from maternity to chronic illness.
How this is accomplished is not as simple as adding pretty curtains
or potpourri to a fitting room, although aesthetics do matter. What
is important is committing to an overall strategy that employs
several targeted steps.

According to experts, there are some specific changes you can
make immediately that will convey your commitment to this market,

  • Offer private, well-decorated fitting room — no one wants
    to try on garments in a restroom
  • Hire fitters who are certified
  • Consider offering a home fitting service
  • Encourage women to come in to see their options before
  • Don't assume complaints from women are emotionally driven
  • Survey your patients to find out where they would like to see
  • Understand and market to all aspects of a female customer's
  • Make it easy for women to buy from you by providing great
    customer service

In marketing to women, many companies make choices that actually
hinder their ability to create profitable relationships with female
customers. According to Andrea Learned, cofounder of ReachWomen
LLC, a marketing and research firm, some of the most common
mistakes companies make when marketing to women are:

  • Thinking women are a niche market when in reality they make
    more than 85 percent of consumer purchases
  • Thinking that the female consumer marketing opportunity
    requires less funding when instead it should be a budget
  • Believing less women than men surf the Internet to research and
    buy products when the 2000 U.S. Census showed that women make up
    more than half of Web users

2000 Breastfeeding Statistics

64% of mothers breastfed early postpartum
29% of mothers breastfed for six months
16% of mothers breastfed for one year

Source: CDC Healthy People 2010 Initiative

National Breast Cancer Awareness Month

October is National Breast Cancer Awareness Month, which offers
many opportunities for HME providers to become involved in
promoting early detection efforts. The following Internet sites
offer a wealth of information on the disease, including screening
guidelines, treatment options and support organizations:

American Cancer Society

National Alliance of Breast Care Organizations

National Breast Care Awareness Month

National Breast Care Coalition

Susan G. Komen Breast Cancer Foundation

Y-ME National Breast Care Organization

Additionally, Oct. 17 is National Mammography Day. On this day
radiologists will provide discounted or free screening mammograms.
In 2002, more than 680 American College of Radiology accredited
facilities took part. To locate radiologists in your area who are
offering this service, contact the American Cancer Society at (800)
227-2345, the National Alliance of Breast Care Organizations at
(888) 806-2226 or the Y-ME National Breast Cancer Organization at
(800) 221-2141.

Stocking Up

Compression therapy products are a natural fit for HME providers
who specialize in women's health care. Support stockings and
medical compression stockings are used for a variety of conditions
and situations, including:

  • Varicose veins
  • Edema
  • Lymphedema
  • Venous Insufficiency
  • Tired, aching legs
  • Legs that feel heavy or swollen

Once known for their “medical” look, today's
manufacturers of compression therapy products focus on performance,
comfort and style with a current emphasis on aesthetics.

“Recent improvement focus on a combination of aesthetics
and comfort,” says Greg Biddulph, marketing manager for Juzo
USA. “Women's hosiery is getting sheerer, softer and more
comfortable. It is also available in a variety of

Because compression hosiery products require replacement, they
offer providers a steady stream of revenue, says Tim Pennington,
national sales manager for Truform, a division of Surgical
Appliance Industries. Pennington says the best method for HME
providers to drive business is to market to their referral network
on a regular basis.

Consumer marketing efforts also pay off. Biddulph encourages
providers to sponsor special events in their stores that emphasize
the need for these products, such as leg screening days.