A simple device to position large/flaccid breasts during tangential breast irradiation.
OBJECTIVE
It is technically difficult to irradiate large pendulous or flaccid breasts with tangential photon fields because they often lie very high or lateral on the chestwall. We, therefore, designed a device to reposition the breast on the chestwall to facilitate treatment.


METHODS
A device to aid in repositioning the breast on the chestwall has been designed. The device consists of a reinforced polyvinylchloride tube formed into a ring that is placed around the breast. A strap around the patient's chest holds the ring in place. The breast tissue is manually moved to the desired position on the chestwall, whereafter the strap is tightened to maintain the position. Treatment setup marks are placed on the skin peripheral to the breast and on the immobilization mold.


RESULTS
Twelve patients with large/flaccid breasts were successfully treated with this device. The technical and physician staff find the reproducibility and acute treatment reactions to be acceptable. Anatomically, the use of this device reduces the volume of lung tissue otherwise included in the tangential fields in patients where the breast lies far lateral. In patients where the breast lies too far cephalad on the chestwall for tangential fields to clear the arm, repositioning of the breast with this device makes tangential fields possible.


CONCLUSIONS
This repositioning appliance aids in the radiation treatment of patients with large or flaccid breasts and, in some instances, renders otherwise nontreatable patients treatable with radiation therapy.
Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710.
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Bentel
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Marks
D001940:Breast / Q000033:anatomy & histology*; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007103:Immobilization; D011878:Radiotherapy / Q000295:instrumentation / Q000379:methods; D015203:Reproducibility of Results