Session Item

This a feasibility study to evaluate the Chabner® Bra as a customized immobilization device for patients with pendulous breast undergoing radiotherapy.

Thirty-four patients with large pendulous breasts were fitted with the Chabner® Bra during CT simulation and treatment procedures (40Gy/15 fractions or /26Gy/5 fractions). A mixed method questionnaire was administered to both radiation therapists (RTTs) and patients to elicit responses from end-users. Staff evaluated the effectiveness of the bra in reducing skin reaction and setup. Patients appraised the bra with regards to the comfort level and ease of wearing. Setup reproducibility was evaluated based on departmental imaging protocol. Acute side effects on the skin were monitored with photo document and assessed using the Radiation Therapy Oncology Group (RTOG) skin toxicity score system during weekly review with oncologists. 

27 (response rate 79.4%) patients completed the self-administered survey. Majority of the patients (n=23) felt comfortable wearing the bra while 20 patients felt less exposed during treatment. Reproducibility of treatment position was acceptable with a median (range) setup error (isocentre) of 0.0cm (-0.6cm to 0.7cm) (left/right), -0.1cm (-0.5cm to 1.2cm) (posterior) and 0.2cm (-0.5cm to 0.9cm) (inferior) achieved based on matched field borders on skin. However, repeated setups and imaging were required for 3 patients due to large breasts size (cups D-G; size 4-5). Minimal skin toxicity (grade 0-1) were observed for all patients at the end of the treatment. No broken skin or adverse skin reactions were reported throughout the course of treatment. 10 RTTs completed the survey. All male RTTs (n=4) were not confident in assisting patients with the fitting of the bra. 8 RTTs agreed that although it was slightly more difficult to reproduce the breast tissue for daily treatment it has helped patient to maintain the treatment position throughout the procedure. 

The Chabner® Bra has demonstrated feasibility for use as a customized breast immobilization device, with adequate patient comfort and setup reproducibility during breast radiotherapy. With minimal skin toxicity, majority of patients also appreciated the additional modesty when wearing the bra.