Theme 1 explored how bra color, price, style, and construction technique contributed to personal well-being and a sense of normalcy. Participants reported a strong emotional connection to colors as they symbolize a return to normalcy and happiness. Bright and cheerful colors evoke happiness and energy, while plain and dark colors convey seriousness or depression [13]. Breast cancer survivors frequently feel a loss of control when dealing with a cancer diagnosis and the ability to make garment choices (e.g., colors) can restore some sense of control. Breast cancer survivors have undergone significant challenges and seek items that can contribute to making life feel more comfortable and enjoyable. However, many breast cancer survivors do not have the financial privilege to prioritize happiness and comfort over cost. Similarly, we observed a tradeoff between enhancing a sense of normalcy and comfort. For example, some participants were willing to wear molded cups when they felt that molded cups enhanced their sense of normalcy, even if the cups were not properly fitted. Differing views on padding and molded cups also highlight the need for customization to cater to breast cancer survivors' unique needs due to substantial variation in the bodily changes resulting from cancer treatment.
Themes 2 and 3 illustrate bra needs change throughout the breast cancer journey, beyond changes that are typical for other bra wearers over their lifespans [14]. In the immediate post-surgery phase, nearly all participants wore front-closure surgical bras due to their restricted movement. However, some participants were frustrated with the hook-and-loop closures, citing discomfort from rubbing on sensitive skin, and with the perceived high price ($100) for a disliked product. Complaints about uncomfortable hook-and-loop closures and front closures seem to be two different issues that are hard to differentiate in this study. Moving beyond the active healing phase, nearly all participants chose to return to back-closure bras, with the most dominant reason being its habitual use. Such habits seem to help patients feel more secure during challenging times. People often use fashion as emotional armor, choosing specific styles for a sense of security. Emotional attachment to clothing can profoundly impact mood by providing familiarity and solace [13, 15]. Another reason participants returned to back-closure bras is the limited adjustability of front closures. Zipper or slider formats are confined to a single size with no flexibility for adjustment. Adjustability is important for accommodating typical fluctuations in body shape and sensitivity. Hook-and-loop or hook-and-eye front closures offer adjustability similar to back-closure bras, but adjusting them can compromise cup shape. Moreover, hook-and-loop closures can cause irritation if not positioned correctly. Future work exploring breast cancer survivors’ perceptions of the textures of hook-and-loop closures could help inform bra design for this population.
Theme 3 also highlights challenges and frustrations participants face in finding bras that meet their specific needs and preferences. Despite receiving suggestions from healthcare providers, and even with the assistance of a bra fitter, the search for a suitable bra can extend for months without success. General suggestions, such as avoiding underwire, do not expedite the search process as this is only one facet of appropriate bra fit. Having assistance from a professional garment fitter can guide both the selection and fitting process, potentially shorten the search time. However, these services are limited to large medical centers and specialty retail stores [1]. Additionally, there are extra charges for the services of a professional mastectomy fitter, and the fitters in retail stores may not have specialized training on the needs of breast cancer patients [16]. Breast cancer survivors report many challenges and frustrations with bras due to an absence or scarcity of suitable options available in the market. For example, participants expressed interest in front closure bras, but reported a lack of comfortable and adjustable front-closure bra options on the market.