A Systematic Review of Postoperative Breast Undergarments for Patients with Breast Cancer Review of postoperative breast undergarments in breast cancer
Abstract
Background: Breast cancer is the most common malignancy among Canadian women, affecting approximately 1 in 8 over their lifetime.(1) Despite advancements in surgical management, many patients experience significant postoperative discomfort.(2-4) This systematic review evaluates existing postoperative breast undergarments and highlights design shortcomings that impact patient recovery.
Methods: A systematic search was conducted using Ovid MEDLINE and EBSCO CINAHL Complete for literature published between January 1, 1946, and April 30, 2025. The search strategy included a combination of Medical Subject Headings (MeSH) and keywords related to breast neoplasms, mastectomy, postoperative care, and support garments. A total of 126 studies were identified, with 11 duplicates removed. After screening, 29 relevant studies were included.
Results: We identified various shortcomings in conventional postoperative garments, including inadequate storage for surgical drains, poor thermoregulation, and materials causing dermatological irritation. Issues such as non-adjustable straps, discomfort from underwires, and a lack of accommodations for breast asymmetry and prosthesis fitting were prevalent. Although newer designs have addressed some of these issues by incorporating features like customizable compression and improved front fasteners, significant gaps remain.
Conclusion: Current postoperative undergarments inadequately address key aspects of recovery for breast cancer patients, particularly in the early postoperative period. There is a clear demand for garments with enhanced comfort, adjustable support, better drain management, and skin-friendly materials. Further design innovation and clinical evaluation are required to optimize postoperative care.
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References
Canadian Cancer Statistics Advisory C. Canadian Cancer Statistics 2022. Canadian Cancer Society; 2022.
Sun Y, Kim SW, Heo CY, Kim D, Hwang Y, Yom CK, et al. Comparison of quality of life based on surgical technique in patients with breast cancer. Japanese Journal of Clinical Oncology. 2014;44(1):22-7. doi:10.1093/jjco/hyt176
Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE. Life after breast cancer: understanding women's health-related quality of life and sexual functioning. Journal of Clinical Oncology. 1998;16(2):501-14. doi:10.1200/JCO.1998.16.2.501
Sieradzki A. Breast Dressing: A Critical Review of Post-Surgical Bras: CUNY Academic Works; 2020.
Liu Y-T, Khan NH, Nicklaus KM, Moix MKB, Liu C, Reece GP, et al. Undergarment Needs and Challenges for Breast Cancer Survivors: A Qualitative Study. Research Square. 2024.
Backman M, Hassan-Nur M, Fridblom K, Johansson H, Fredholm H, Fredriksson I. OptiBra study, a randomized controlled trial on optimal postoperative bra support after breast cancer surgery. European Journal of Oncology Nursing. 2023;63:102285.
Ng RP, Allen JC, Chia Y-Y, Lim GH. Conventional standard-sized bra with prosthesis or patient's bra with customized hand-knitted external prosthesis after mastectomy: Mixed-methods evaluation of patients' preferences. Breast Disease. 2023;42(1):375-82.
Watanabe S, Saiga M, Motoki T, Shien T, Taira N, Doihara H, et al. Safety and Efficacy of a Well-Fitting Brassiere after Breast Reconstruction: A Qualitative Study. Acta Medica Okayama. 2023;77(1):11-9.
Leung K, Shin K, Han F, Jiao J. Ergonomic mastectomy bra design: Effect on core body temperature and thermal comfort performance. Applied Ergonomics. 2021;90:103249. doi:10.1016/j.apergo.2020.103249
Jones M, Mills C, Exell T, Wakefield-Scurr J. A novel multi-study intervention investigating the short and long term effects of a posture bra on whole body and breast kinematics. Gait & Posture. 2021;83:194-200. doi:10.1016/j.gaitpost.2020.10.031
Qiu J, Hou S, Li P, Huang L. Medical professionals' knowledge of the use of external breast prostheses among breast cancer patients in China-a cross-sectional study. Gland Surgery. 2021;10(2):595-606. doi:10.21037/gs-20-657
Li JX, Gao J, Song JY, Li HP, Yang WJ, Tong DT, et al. Compression therapy for the patients with breast cancer. Cancer Nursing. 2021;45(4). doi:10.1097/NCC.0000000000001005
Shima H, Kutomi G, Sato K, Kuga Y, Wada A, Satomi F, et al. An Optimal Timing for Removing a Drain After Breast Surgery: A Systematic Review and Meta-Analysis. Journal of Surgical Research. 2021;267:267-73. doi:10.1016/j.jss.2021.05.031
McGhee DE, Mikilewicz KL, Steele JR. Effect of external breast prosthesis mass on bra strap loading and discomfort in women with a unilateral mastectomy. Clinical Biomechanics (Bristol, Avon). 2020;73:86-91. doi:10.1016/j.clinbiomech.2019.12.027
Nicklaus KM, Bravo K, Liu C, Chopra D, Reece GP, Hanson SE, et al. Undergarment needs after breast cancer surgery: A key survivorship consideration. Supportive Care in Cancer. 2020;28(8):3481-4. doi:10.1007/s00520-020-05414-z
Wroblewski SM, MacGillivray MS, Cheng CI. Bra preferences of breast cancer survivors treated with mastectomy and prosthetic reconstruction. International Journal of Fashion Design, Technology and Education. 2020;13(1):31-44. doi:10.1080/17543266.2020.1718776
Shin K, Leung K, Han F, Jiao J. Thermal and moisture control performance of different mastectomy bras and external breast prostheses. Textile Research Journal. 2019;89(17-18):3751-63. doi:10.1177/0040517519881815
Piroth MD, Petz D, Pinkawa M, Holy R, Eble MJ. Usefulness of a thermoplastic breast bra for breast cancer radiotherapy: A prospective analysis. Strahlentherapie und Onkologie. 2016;192(9):609-16. doi:10.1007/s00066-016-0985-3
Lopes WMPS, Figueiredo M, Luz M. The knowledge and the use of bra and external prosthesis for mastectomized elderly women. Journal of Nursing Ufpe Online. 2016. doi:10.5205/1981-8963-V10I11A11484P4015-4020-2016
Ergün SS, Baygöl EG, Kayan RB, Kuzu İM, Akman O. Correction of Brassiere Strap Grooves with Fat Injections. Aesthetic Surgery Journal. 2015;35(5):561-4. doi:10.1093/asj/sjv007
Coltman CE, McGhee DE, Steele JR. Bra strap orientations and designs to minimise bra strap discomfort and pressure during sport and exercise in women with large breasts. Sports Medicine - Open. 2015;1(1):21. doi:10.1186/s40798-015-0014-z
Gho SA, Munro BJ, Jones SC, Steele JR. Evidence-based recommendations for building better bras for women treated for breast cancer. Ergonomics. 2014;57(5):774-86. doi:10.1080/00140139.2014.897377
Gho SA, Steele JR, Munro BJ. Is bra discomfort a barrier to exercise for breast cancer patients? Supportive Care in Cancer. 2010;18(6):735-41. doi:10.1007/s00520-009-0705-y
Gho SA, Steele JR, Jones SC, Munro BJ. Self-reported side effects of breast cancer treatment: a cross-sectional study of incidence, associations, and the influence of exercise. Cancer Causes Control. 2013;24(3):517-28. doi:10.1007/s10552-012-0142-4
Bradbury C, Parvaiz MA, Sircar T. Innovative postoperative bra for patients with drains following breast surgery. Annals of the Royal College of Surgeons of England. 2014;96(3):241. doi:10.1308/003588414X13814021676503
Keller LMM, Cohen R, Sopka DM. Effect of bra use during radiation therapy for large-breasted women: Acute toxicity and treated heart and lung volumes. Practical Radiation Oncology. 2013;3(1):9-15. doi:10.1016/j.prro.2012.05.007
Risius D, Thelwell R, Wagstaff C, Scurr J. Influential factors of bra purchasing in older women. Journal of Fashion Marketing and Management. 2012;16:366-80. doi:10.1108/13612021211246011
Chadha NK, Cumming S, O'Connor R, Burke M. Is discharge home with drains after breast surgery producing satisfactory outcomes? Annals of the Royal College of Surgeons of England. 2004;86(5):353-7. doi:10.1308/147870804263
Laura S, Clark D, Harvey F. Patient preference for bra or binder after breast surgery. ANZ Journal of Surgery. 2004;74:463-4. doi:10.1111/j.1445-2197.2004.03019.x
Greenbaum AR, Heslop T, Morris J, Dunn KW. An investigation of the suitability of bra fit in women referred for reduction mammaplasty. Br J Plast Surg. 2003;56(3):230-6. doi:10.1016/s0007-1226(03)00122-x
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