Published 12:00 am Friday, June 1, 2007

By Katie Scarvey
Salisbury Post
Joyce Salvatoriello is missing her left breast.
She doesn’t have a problem talking about it.
It’s just a fact of her life, for now. She also doesn’t mind lifting off her wig to show you her head ó mostly hairless because of the effects of chemotherapy.
She keeps a sunny outlook.
“You win some and you lose some,” she says simply, with a distinctive Jersey accent she hasn’t lost in the eight years she’s lived in Salisbury.
Salvatoriello is happy to talk about her experience in order to help women cope with the after-effects of having a mastectomy. And she’s happy that she found Deborah Bowman of Attractions on Main ó which is the only place locally where women can be fitted with breast prostheses.
Salvatoriello, who works for Rowan Regional Medical Center, went for a routine mammogram in November. After looking at the results, her doctor told her she needed to have an ultrasound, which led to a tissue biopsy,which confirmed the original suspicions: she had breast cancer.
Salvatoriello had surgery to remove her left breast in January, followed by chemotherapy. Because she wants to give herself the best possible chance of survival, Salvatoriello will have her other breast surgically removed later this year.
After she’s finished with seven weeks of chemotherapy, she will face seven weeks of radiation starting in July.
So far, her life has been minimally disrupted. She’s fortunate that she feels good enough to continue to go to work every day.
Sometimes though, fatigue takes its toll. Once, when she was in Wal-Mart with her boyfriend, she got so tired that he ended up literally carrying her out of the store.
“It’s a good thing that he’s a big guy,” she says.
Like most women who have mastectomies, Salvatoriello wanted to start feeling normal again as soon as possible. Part of that included being fitted with a breast prosthesis.
A breast prosthesis is an artificial breast form that can be worn after the breast has been surgically removed. They may be made from silicone gel, foam, fiberfill or other materials that feel similar to natural tissue. Most are weighted to give them the same feel as the remaining breast (if only one breast has been removed). Some are worn next to the skin; others are worn as bra inserts.
After her surgery, Salvatoriello began looking for information about where to get a breast prosthesis and found out about Attractions on Main, a clothing boutique at 2130 S. Main St. Deborah Bowman, who owns the business with husband Rick, who handles the salon side of the business, is a certified breast prosthesis fitter, as is her mother, Jeanette Kesinger.
Bowman says that most people learn about their prosthesis service from their doctors. Bowman has donated some gift bags to local surgeons to distribute to women facing a mastectomy. Each contains a breast cancer pin, a notepad, a water bottle and some educational material about what they can expect after surgery and about what they might need.
“Doctors don’t get into this kind of stuff,” Bowman says.
Before she came to see Bowman, Salvatoriello had been wearing a foam rubber prosthesis she’d ordered online.
There came a point at which she realized she needed something better. During a presentation at work, “my boob came flying out,” she said. Well, not really flying out, but the prosthesis had worked its way up her chest and was peeking out of her blouse ó not really the impression she wanted to make.
She’s been thrilled with the prosthesis Bowman fitted her with.
“I don’t feel like I have anything on,” she says.
Prosthesis technology has come a long way in recent years. Breast prostheses available now are much lighter than even those of four years ago.
Most of the prostheses that Bowman sells are inserts made of silicone that the wearer inserts into a bra made especially for them. Another type adheres directly to the skin, but most women prefer the kind that is inserted into a bra, Bowman says.
Some women who undergo mastectomies will choose to have reconstructive surgery. Salvatoriello is among those ó “I’m going to get perky boobs in September,” she says, laughing. Some women choose not to undergo additional surgery and continue to wear prostheses.
For now, Salvatoriello is happy to have a prosthesis that looks and feels good.
For the comfort and privacy of her clients, Bowman uses a spa room to do fittings.
“It’s a good setting,” Salvatoriello says. “It’s private and nice and homey.”
Bowman likes to educate her customers about what is available to them if they are covered by Medicare.
Women can order a new breast prosthesis every 24 months, with a significant portion covered by Medicare, which will also pay costs on four to six bras a year for those who have had mastectomies.
Bowman says that one popular item is a post-surgery camisole. Since women can’t wear bras right after surgery, the camisole ó which features drain pockets ó gives those recovering from a mastectomy something to wear as they heal.
Salvatoriello also has a swim form, which is a popular item since regular a regular prosthesis can’t be worn in chlorinated water.
Bowman got into the breast prosthesis business about four years ago, when Underwood’s in downtown Salisbury closed.
Bowman had gone into the store to see about buying some clothing racks when Faye Lippard, an Underwoods employee, suggested that Bowman look into providing breast prostheses, since Underwoods would no longer be providing that service. Bowman wasn’t convinced, but Lippard was encouraging, assuring her that she could learn what she needed to know to get certified.
Bowman and her mother both went to a certification class through one of the largest prosthesis companies, Amoena, whose product Bowman loves.
She also carries products from American Breast Care (ABC), another big company, and she encourages women to compare the products in order to select what is most appropriate for them.
A fitter must figure out the proper size and shape for the prosthesis, which involves a lot of measuring and a keen eye.”You have to look and see what they’re missing and fill it in,” Bowman says.
Fittings, which are free, take about 15 or 20 minutes, she says. A prosthesis costs from $295 to $495, Bowman says, with the typical one in the $345 range. The bras run from $40-$47. Insurance varies but often covers a significant portion of prostheses.
When women come in to replace an old prosthesis, Bowman recommends that they get refitted instead of simply ordering what they had the last time.
Gaining or losing even a small amount of weight can have a significant effect on the fit, she says.
Bowman gets a lot of satisfaction out of providing something that makes women feel good.
“Women love it so much; they’ll wear it out the door. It’s so comfortable they want to wear it home.
“That’s very satisfying.”
For more information, contact Deborah Bowman at Attractions on Main at 704-639-1602.
Contact Katie Scarvey at 704-797-4270 or