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Use of immobilisation bra for daily setup of patients with pendulous breasts undergoing radiotherapy

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Abstract

Purpose

A feasibility study to evaluate the Chabner XRT® Radiation Bra (CIVCO Radiotherapy & Qfix, Coralville, IA, USA) as a customised immobilisation device for patients with pendulous breasts undergoing radiotherapy was conducted.

Methods

A total of 34 patients with large pendulous breasts were fitted with the Chabner XRT® Radiation Bra during RT. A mixed-method questionnaire was administered to both radiation therapists (RTTs) and patients. RTTs evaluated the effectiveness of the bra in setup. Patients appraised its comfort level and ease of wearing. Setup reproducibility was evaluated based on a departmental imaging protocol. Acute skin side effects were documented with photos and assessed using the Radiation Therapy Oncology Group (RTOG) classification.

Results

Of the patients, 27 (79.4%) completed the questionnaire. 23 patients felt comfortable wearing the bra while 20 felt less exposed during treatment. Reproducibility was acceptable, with a median (range) setup error (isocentre) of 0.0 cm (−0.6 to 0.7 cm; left/right), −0.1 cm (−0.5 to 1.2 cm; posterior) and 0.2 cm (−0.5 to 0.9 cm; inferior) achieved based on matched field borders on skin. However, repeated setups and imaging were required for 3 patients due to large breast size (cups D–G; size 4–5). Minimal skin toxicity (grade 0–1) was observed. No grade ≥ 2 was reported. 10 RTTs completed the survey. Male RTTs (n = 4) were not confident in assisting patients with bra fitting. 8 RTTs agreed that although it was difficult to reproduce the breast tissue for treatment, it helped patients to maintain the treatment position.

Conclusion

Our study demonstrated the feasibility of using a customised bra which provided optimal setup reproducibility while maintaining minimal skin toxicity and patient comfort, especially the value-added modesty felt among Asian women during their breast cancer radiotherapy.

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Change history

  • 08 September 2023

    The ORCID of E. P. P. Pang has been added.

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Author information

Authors and Affiliations

  1. Division of Radiation Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore

    J. Z. Chua MSc, L. H. Lim MSc, E. P. P. Pang PhD &  G. Kusumawidjaja FRCR

  2. Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore, Singapore

    E. P. P. Pang PhD &  G. Kusumawidjaja FRCR

Authors
  1. J. Z. Chua MSc
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  2. L. H. Lim MSc
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  3. E. P. P. Pang PhD
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  4. G. Kusumawidjaja FRCR
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Corresponding author

Correspondence to G. Kusumawidjaja FRCR.

Ethics declarations

Conflict of interest

J.Z. Chua, L.H. Lim, E.P.P. Pang and G. Kusumawidjaja declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

The authors JZ Chua and LH Lim contributed equally to the manuscript.

Supplementary Information

66_2023_2131_MOESM1_ESM.docx

Questionnaires for patients (top) to evaluate their comfort level and radiation therapists (RTT) (bottom) to assess the issues related to the use of immobilisation bra.

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Chua, J.Z., Lim, L.H., Pang, E.P.P. et al. Use of immobilisation bra for daily setup of patients with pendulous breasts undergoing radiotherapy. Strahlenther Onkol 200, 287–295 (2024). https://doi.org/10.1007/s00066-023-02131-4

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  • DOI: https://doi.org/10.1007/s00066-023-02131-4

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