2714 - The Impact of a Bra upon Inframammary Skin Fold Measurements for Large-Breasted Women, Positioned Upright

J. Nunn¹, G. Sands², M. Kissick³, E. Chabner⁴, and T. S. A. Underwood¹; ¹Leo Cancer Care, Surrey, United Kingdom, ²Leo Cancer Care Ltd, Smallfield, United Kingdom, ³Leo Cancer Care, Middleton, WI, ⁴Chabner XRT, Scarsdale, NY

Purpose/Objective(s): When considering RT for breast cancer, patients with large breasts have historically experienced more acute and late skin toxicities, where their treated breast folds onto skin below. Further, patients who undergo breast RT while topless can feel exposed and vulnerable. Despite these known issues, there is a paucity of research on the potential use of bras within RT. This work aimed to assess the effectiveness of a commercially available bra (designed as an immobilization accessory for RT), in reducing / eliminating inframammary skin folds (ISF). This research was conducted as part of a larger study which considered upright body positioning for RT. Materials/

Methods: Research Ethics Committee approval was obtained to fit healthy women volunteers with the Chabner XRT bra, and assess their views on bra comfort using a questionnaire. Recruitment targeted large-breasted women (n=21): the participants’ minimum (measured) UK bra cup size was C, the median was DD and the maximum was H. The participants were aged 24-83 (mean=59). Assuming a left-sided RT treatment, lifting the left breast was prioritized during fittings. ISFs with and without the bra were determined for each breast, using a tape measure, for two upright body positions (arms up and arms down).
Results: A one-tailed t-test indicated that the bra significantly reduced measured ISFs (p<0.001, both paired & unpaired) for the left and right breasts, for upright arms up, and upright arms down body positions. In the arms up position, the bra completely eliminated the left breast ISF for 86% (18/21) women. For the remaining 3 women, the mean left breast ISF was reduced from 6.7cm with no bra, to 1.2cm with the bra. In the arms down position: the bra completely eliminated the left breast ISF for 48% (10/21) women. For the remaining 11 women, the mean left breast ISF was reduced from 5.8cm with no bra to 2.3cm with the bra. The bra’s impact upon ISF measurements was lower for the right breast compared to the left (lift on the left side was prioritized during fittings). Questionnaire results indicated that 100% of the healthy volunteers felt: 1) the bra covered them well, 2) supported by the bra and 3) comfortable after the bra was adjusted. A minority (2/21, 9.5%) reported pressure/discomfort as the bra was fitted and relief when it was removed. 62% (13/21) indicated that being treated wearing the bra would be preferable to being treated without wearing the bra, with the remaining 38% (8/21) indicating that they would have no preference either way.
Conclusion: For a cohort of large-breasted healthy volunteers, the radiation bra substantially and significantly lifted the breasts, reducing measured ISFs for upright body positions. Use of the bra was viewed favourably in terms of comfort and modesty. Further research is warranted to consider inter-fraction reproducibility of breast tissue within the bra for conventional treatment positions (e.g. supine with a breast board), plus the bra’s impact upon RT treatment plans.