The SuPPORT 4 All project has developed a specially-designed bra that lifts women’s breasts away from their ribcage to ensure they are in the same position during radiotherapy.
The project, led by professor of radiotherapy and oncology Heidi Probst at Sheffield Hallam University, also seeks to improve patient experiences of chest radiotherapy.
Professor Probst said that when speaking with patients, she found many of them had not had positive experiences with their radiotherapy.
A 'disempowering process'
She said: “They talked about how disempowering the process was, and we were really shocked about that. It was not what we were expecting. Patients have talked about how they have felt vulnerable when on the treatment bed, nervous, afraid and disempowered.
“And so in addition to providing some technical support and reducing side effects, we're hoping that the bra will provide an element of empowerment.
“We're trying to involve patients in the process. Rather than just having all this stuff done to them, we’re trying to make them a part of it, and they sort of own their treatment, or have elements of it that they are involved in. It’s an opportunity for us to work in partnership with patients, and also with our colleagues in the clinical setting.
SuPPORT 4 All began in 2013 with initial funding from Sheffield Hallam to develop the bra together with patients and a commercial lingerie company.
Professor Probst explained the idea came from her experience as a radiographer in clinical practice, where her biggest workload came from patients with a breast cancer diagnosis who have been referred for post-operative radiotherapy.
“We used to struggle to provide really accurate, reproducible positioning for those patients with slightly larger breasts,” she said. “You had to spend quite a bit of time making sure they were positioned accurately. It struck me as really odd we immobilise patients for head and neck cancers, we have specific devices for that, but not for breast cancer.”
Dignity and modesty
Moreover, Professor Probst was concerned with patient dignity and modesty following surgery, with patients potentially suffering from altered body image.
While the aim of breast cancer radiotherapy is to treat all the breast tissue following the removal of the tumour, there is risk of harming the sensitive organs nearby, such as the heart and lungs.
Due to the way the breast falls laterally when people lie down, there is risk of needing to bring radiation beams further out, potentially irradiating more of the breast for longer.
Professor Probst added: “It just struck me that we could do better. We must be able to support the patient with better dignity, while also lifting the breast away from the chest wall and all those sensitive organs.”
Developing a suitable immobilisation device for the breast faced complications, however – patients with larger breasts tend to develop worse skin reactions, and a systematic review of other potential devices found there was nothing out there working at satisfactory levels.
“We thought, there actually is a gap here that we could build on and support patients,” Professor Probst continued. “That’s where it came from.”
Full rollout
Since its inception, the SuPPORT 4 All project has received funding from the university, from charities, and has received a grant from the the National Institute for Health and Care Research’s Innovation Pathway.
Once they had developed a prototype, co-designed with patients and healthcare practitioners, it went through physical testing using linear accelerators, then on health volunteers, before finally running a randomised clinical feasibility study in 2019/20.
The results of the randomised clinical feasibility trial can be found here.
Now, the project is developing the fitting process to be fast enough to ensure the pathway isn’t delayed, as well as expanding the feasibility study to a broader population size.
Once that is completed, the team will be able to seek commercial partners for wider rollout of the bra, making it available to women and hospitals across the country.
More information about the SuPPORT 4 All project can be found here.
(Image: The SuPPORT 4 All team, via Sheffield Hallam University)