Published Report
Breastboard system for Carcinoma of the breast.
-by Donland Dea, chief dosimetrist, University of California Medical Center
Breastboard systems are designed and manufactured to help support and immobilize patients treated in radiotherapy for carcinoma of the breast. They provide comfortable support, immobilization, reduction in material costs and setup time, and better accuracy and reproducibility. Breastboards are “tilt boards” designed with more sophisticated features. They are tailored to breast treatment techniques used in radiotherapy. Tilt boards, also known as slant boards, angle boards, or elevating back supports, are used to support the patient’s back and head at an incline. These boards usually have an array of hand and head support positions to from. This feature allows us to tailor-fit the treatment to the treatment technique, adding to the patient’s comfort. Because breastboards are tilt boards, they can be used for head and neck as well as upper thorax treatments. So, the breastboard system is really a two-in-one system.
Why use a breastboard system?
A breastboard system is used to support and immobilize the patient in a position that allows us to treat only the desired breast tissue. It has been noted that by tilting the patient off the treatment couch surface, we are able to achieve this goal more easily. Like many institutions, our department used a two-part foam system to provide support and immobilization for breast patients.
So why did we switch to a breastboard system?
There are three reasons to consider “switching” to a breastboard system if you are not currently using one. The first is “cost effect.” With a breastboard system, there is no additional cost after the original purchase of the board (except for thermoplastic if used). The second reason is that changes can be made without having to purchase additional materials. The third reason is reproducibility. You can easily record and retrieve all setup data on a worksheet, making it fast and simple to reproduce the patient’s setup position. One incident I can relate that explains the importance of reproducibility involved a previously-treated patient with carcinoma of the breast who returned to our radiation oncology department for a simulation procedure to the opposite breast. The procedure involved getting the patient into the same setup position that was used several years before. The patient was originally treated using two-part foam support. Remaking a two-part foam support to match the one used years before was extensive and time-consuming. Only a Polaroid picture of the patient in the foam support was available to help make the new support. Although it was very difficult to achieve, we did make another foam support. The simulation procedure was one very big nightmare, taking more than three hours to complete. The nightmare haunted me for days. Then I decided to do something about it. I started by looking at catalogs to see what accessories could be used to avoid this problem in the future.
Breastboards!
How can these boards help? I asked myself this question over and over. Then I called MEDTEC and asked for a trial use of the MT-250 breastboard system with the elevation rod. This breastboard system closely met our breast setup requirements. MEDTEC’s breastboard was designed for today’s and tomorrow’s technology. I worked with MEDTEC for over a year, suggesting and implementing some modifications to their MT-250 breastboard. MEDTEC has since added to their list of breastboard options a Timo head and neck support and removable referencing extension accessories used to reference the patient to the board. To make transport of the breastboard from storage to the treatment couch easier, the board can separate into two lightweight and easy-to-handle pieces. The breastboard also accommodates a thermoplastic breast support system if desired. The MT-250 breastboard comes with a setup worksheet that is used to record the location of the head support, as well as the arm and wrist supports. This worksheet is kept as a permanent document in the patient’s chart. If at any time the patient needs to be reset to treatment parameters, the data can easily be retrieved. When comparing this breastboard system to two-part foam, our therapists and doctors prefer the breastboard. They are very impressed with the speed and accuracy this system provides.
Abstract:
Breastboard System for Carcinoma of the Breast. Dea, Donald.
TECtimes Newsletter. Fall 1996.
