Evidence-based recommendations for building better bras for women treated for breast cancer

Ergonomic mastectomy bra design: Effect on core body temperature and thermal comfort performance

The accumulation of sweat and heat between the skin and the prosthesis is one of the common causes of discomfort experienced by post-mastectomy women who wore silicone-type external breast prostheses. This study aimed 1) to investigate the effect of a newly designed heat-reduction mastectomy bra on the thermal responses and thermal comfort performance; and 2) to propose an evaluation protocol for post-mastectomy products. The heat-reduction bra and the conventional bra were made of the same textile materials but the cup of the bra under discussion had a polyurethane cup with a perforated structure along the breast root/inframammary fold. The inframammary fold is often aggravated by heat, sweat, maceration, chafe, and lack of air circulation. Nine healthy male participants were recruited to participate in the study since the women who had undergone double-mastectomy were sensitive about their scars. An ingestible telemetric pill sensor was used to collect the data of core body temperature. Participants performed a 70-min five-phase exercise protocol wearing the heat-reduction bra and the conventional bra together with a silicone prosthesis with ventilation holes on the bottom. Physiological responses (i.e., core body temperature, skin temperature, temperature between bra and prosthesis, skin humidity and humidity between bra and prosthesis) and subjective sensation responses were measured. The results were statistically significant and the conventional mastectomy bra showed a higher core body temperature than that of the heat-reduction mastectomy bra (37.3 ± 0.3 °C to 38.2 ± 0.5 °C vs. 37.2 ± 0.3 °C to 38.0 ± 0.3 °C) starting from the middle of the sitting phase to the running phase and post-exercise resting (F = 164.2, p < 0.001). Both factors, the bra and the phase, have significant effects on the core body temperature (F = 14.5, p < 0.001). The heat-reduction mastectomy bra demonstrated optimum thermal comfort performance in both the temperature and humidity than the conventional mastectomy bra.

Biomechanics of Breast Support for Active Women

More systematic breast biomechanics research and better translation of the research outcomes are necessary to provide information upon which to design better sports bras and to develop effective evidence-based strategies to alleviate exercise-induced breast pain for women who want to participate in physical activity in comfort.

Diagnosis and Treatment of Edema and Lymphedema in the Cancer Patient

BACKGROUND

Lymphedema occurs commonly in cancer survivors. It is crucial to properly assess cancer patients in order to distinguish lymphedema from general edema and to initiate evidence based treatment.

PURPOSE

To provide evidence based recommendations for screening, evaluating, and treating lymphedema and to establish the role of the nurse in the care of patients with lymphedema.

METHODOLOGY

Comprehensive overview with narrative literature review of evidence based lymphedema diagnosis and treatment.

FINDINGS

Cancer-related edema represents numerous complex conditions. A variety of interventions are needed to address prevention, early detection, patient education, and effective treatment.

CONCLUSION

Lymphedema treatment is complex and multimodal, and is provided by an interdisciplinary team of properly trained professionals. Nurses play a major role in evaluating, treating and educating patients on the signs and symptoms of cancer-related edema and patient self-management.

CLINICAL IMPLICATIONS

Evidence-based assessment and treatment should be initiated early to improve outcomes and quality of life in patients with cancer-related lymphedema.