A breast cancer diagnosis can affect all parts of a person’s life. Even after remission and recovery, scars from a lumpectomy or mastectomy can serve as a reminder of the pain of the past. That’s where Lorraine Dressel and Cathy Rieckenberg come in.
The pair of registered nurses run Underneath It All, an Eden Prairie store that lies at the intersection of medicine and clothes. They outfit people who have had mastectomies or lumpectomies with a bra that fits, prosthetics and a community.
“They’re like family, a lot of them,” Dressel said of their clients.
Over their 20 years working in the breast cancer survivor community, the pair has witnessed a sea change in how the illness is perceived and treated.
“When Cathy and I first started, there were women who didn’t tell their families” about their mastectomy, Dressel said. “There was one woman who was 10 years out and she’d never looked at herself in the mirror.”
Dressel and Rieckenberg will often meet a client before her surgery to discuss her options and goals for recovery and prosthetics. The session is part informational, part talk therapy, Dressel said. Everybody approaches their surgery differently — some people don’t put much emotional stock in their breasts and are relatively unbothered by losing one or both; others take the loss with great difficulty.
“You really have to listen to them and take your path from there,” Dressel said.
Dressel, Rieckenberg and Underneath It All’s three other fitters go into each fitting with hundreds of hours of training and experience. Each are certified through the Board of Certification, and three — including Dressel — have the experience of surviving breast cancer. When she was overwhelmed by information from her doctor, the community at Underneath It All provided the support she needed, Dressel said.
“And seven years later, people still think to ask me how I’m doing,” she added.
Marti Auringer is a registered nurse at St. Francis Medical Center in Shakopee and has worked with breast cancer patients for over 20 years. She often connects her patients with the resources at Underneath It All, she said.
“I could go on and on and on about how wonderful these women are,” Auringer said of Dressel and Rieckenberg. “They just make every woman feel so special.”
Auringer has seen many patients who, unaware of their options for prosthetics, will stuff their bras with tissue or even socks to achieve a level of symmetry.
“I can’t stress enough how body image and self esteem is altered after a mastectomy,” she said. “It doesn’t define you, but it is an important part of you.”
A well-fitted prosthetic can make the all the difference of feeling whole. Rieckenberg recalled fitting a woman who had a double mastectomy and the immediate change in her demeanor after receiving her prosthetics.
“She came in with a baggy shirt and she left with her shirt tucked in. That sort of said it all,” she said.
Dressel and Rieckenberg met while they were nurses at Ridgeview Medical Center in Waconia in the 1980s. They noticed medical equipment like oxygen tanks and prosthetics were delivered infrequently and often without the education to go along with it, which turned on a lightbulb in Rieckenberg’s head. Together, they left Ridgeview to start a mobile medical closet that delivered essential equipment and training across Minnesota.
Dressel and Rieckenberg spent nine years running that business and eventually sold most of the business to Ridgeview in 1998. However, the medical center wasn’t interested in the breast prosthetics or mastectomy bras. The duo decided to dive deeper into that part of the business, launching what would become Underneath It All.
At first, they kept the mobile aspect of their business, doing appointment-based fittings from Coon Rapids to New Ulm. A flaw quickly emerged: “Most women wear the wrong size bra anyhow,” Rieckenberg explained. “When people say, ‘I’m a B cup,’ well, there are three different B cups.”
When a client gave an incorrect bra size — and guessing one’s size after a mastectomy or lumpectomy can be even trickier — Rieckenberg showed up with an array of bras and prosthetics that wouldn’t work and would have to scrap the visit.
Underneath It All soon settled into a retail space at 7942 Mitchell Road in Eden Prairie, creating space to showcase its full collection of bras and prosthetics and host support groups as well.
Dressel and Rieckenberg still travel, though. Based on requests from breast cancer support groups and elderly populations who can’t travel to Eden Prairie, they make fitting stops across the state from Hennepin County Medical Center to Buffalo, Monticello, Faribault, New Ulm and Hutchinson, among other places.
Having a central location helps build community as well. Women who are seeking their first prosthetic or specialty bra have the chance to bump into clients who have been coming to Underneath It All for years, Rieckenberg said, and they begin to connect over their shared experience.
“You just get them near each other,” she said. “It’s wonderful to hear their stories.”
Another reason for the physical location is to make it easier for Dressel and Rieckenberg to handle the tangle of insurance claims around their products. Most insurance plans cover a mastectomy bra or prosthesis, but the fitter needs to write a prescription for the products, which they can’t do if women order a bra or prosthetic online.
On top of that, some plans will pay for several bras a year and others, only one. Rieckenberg said she’d encountered an insurer that would only cover one new bra every five years.
“And then we go, really? Do you wear the same bra for five years?” she said. “We go to bat for women.”
To counter rising operating costs and lowering reimbursement rates from insurers — and to help clients feel like they’re having a regular shopping experience — Underneath It All has begun carrying a few retail clothing lines. The store has a newsletter and is hosting its annual open house on May 1, but as they look to the future, Dressel and Rieckenberg hope to elevate their online presence. Rieckenberg’s granddaughter is helping them learn how to cultivate that presence, she said.
“They say we need to blog, we need to Twitter, we need to get to the younger women,” Rieckenberg said.
Those same younger women are creating changes in the breast cancer community, the pair noted. As a younger generation survives a diagnosis and seeks out options for their post-mastectomy wardrobe, manufacturers have begun to cater to their style needs. Now, clients can find seamless or lacy bras and even swimsuits and sports bras with pockets for prosthetics.
“In the beginning they were very matronly,” Dressel said.
“Times have changed,” Rieckenberg noted.
Even with the pressure of changing insurance and retail trends, the pair anticipates running Underneath It All for a long time to come.
“People say, why aren’t you retired? I consider this my volunteering,” Rieckenberg said.
“It’s the most satisfying job I’ve ever had. It’s not really a job,” Dressel agreed. “You can help (women) on the beginning of that journey they’re going to take.”