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A service evaluation of the immobilisation techniques adopted for breast cancer patients with large and/or pendulous breasts, receiving external beam radiotherapy

Published online by Cambridge University Press:  13 January 2020

Lisa Montgomery
Affiliation:
Belfast Health and Social Care Trust, Belfast City Hospital, BT9 7AB Northern Ireland, UK
Terri Flood
Affiliation:
School of Health Sciences, Ulster University, Jordanstown Campus, Newtownabbey, County Antrim BT37 0QB, Northern Ireland, UK
Paul Shepherd
Affiliation:
School of Health Sciences, Ulster University, Jordanstown Campus, Newtownabbey, County Antrim BT37 0QB, Northern Ireland, UK
Corresponding
E-mail address:

Abstract

Introduction:

Breast cancer patients referred for external beam radiotherapy and who have large and/or pendulous breasts can present positioning and immobilisation challenges. Deep infra-mammary and/or lateral wrap skin folds can occur that can lead to unwanted radiation-induced skin toxicity. The purpose of the study was to evaluate the immobilisation techniques adopted for this subgroup of patients in order to inform best practice.

Method:

A survey aimed to identify the current clinical practice in radiotherapy centres throughout the United Kingdom and Ireland was undertaken. The email survey was distributed with support of the Radiotherapy Services Managers group.

Results:

Twenty-six of the 74 radiotherapy centres responded to the survey. Responses demonstrated that supine positioning with or without additional immobilisation was preferable. Of the eight different immobilisation techniques identified, patients positioned supine on a breast board wearing a bra was the most common. Only two of the centres reported using a prone technique.

Conclusions:

Immobilisation and reproducibility are key for successful external beam radiotherapy particularly when advanced treatment techniques are being employed. No single technique gained widespread acceptance as the optimum for the effective immobilisation of patients with large and/or pendulous breasts. Further evaluative research in the form of a multi-centre trial is warranted in order to clearly establish the most effective immobilisation methods/devices for this ever expanding, subgroup of cancer patients.

Type
Original Article
Copyright
© The Author(s) 2020. Published by Cambridge University Press.

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