Abstract:
A device for supporting a breast during treatment. The device includes a support arm having one or more indexed joints for repeatably positioning the device relative a patient&#39;s breast. The device includes a scoop for wedging against the patient&#39;s breast for forming the breast to a preferred shape during treatment.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     This application claims the benefit of U.S. Provisional Application No. 61/474,893, filed Apr. 13, 2011, the disclosure of which is hereby incorporated by reference. 
    
    
     BACKGROUND OF THE INVENTION 
     Medical treatment of the breast, such as radiation treatment, can be effective in treating cancers and other ailments. For such treatment to be most effective, the treatment must be targeted at the affected tissue in such a way that damage to surrounding tissue is minimized. Such targeting is more difficult on patients who have large or pendulous breasts. One common side-effect of radiation treatment of the breast is irritation to the skin in the area surrounding the affected tissue. Such treatment can also result in an increased dose of treatment to the lungs. Additionally, in some cases such treatment, when applied to the left breast, may need to be reduced to prevent the dose affecting the heart, and as a result an insufficient dose is applied. 
     In order to allow for proper treatment of a large or pendulous breast, it is often necessary to provide support to the breast to bring the breast to a more bulbous shape. One way to form the breast to a bulbous shape is to treat the patient in a prone position (such as lying face-down). The downside of treating patients in the prone position is that many patients who require such treatment are unable to maneuver themselves onto a table and into the prone position due to their increased age or other physical limitations. Another way to form the breast to a bulbous shape is to use an external support device to shape the breast into an ideal shape. In many cases, such prior art external support devices are generally crude homemade instruments constructed from objects on hand in the treating office, such as plastic film, or tape. 
     Any external support device used during such treatments needs to be able to return the breast to a repeatable shape during each of successive treatments. As such, the prior art “homemade” solutions are inadequate, as they do not lend themselves to consistent and reproducible shaping of the breast. In the common case, a patient will need to receive multiple treatments over a series of visits, and the treatments need to be consistent. As such, the positioning of the patient, and the positioning of the breast needs to be accurately reproducible from visit to visit so as to provide consistent and repeatable dosing to the affected tissue while minimizing dosing to unaffected tissue. 
     As such, an improved external support device for breasts is needed. 
     SUMMARY OF THE INVENTION 
     The present disclosure describes a breast support device for shaping and supporting a breast during treatment. The breast support of the present disclosure includes a scoop which contacts and shapes the breast. The scoop is carried by a support arm. The support arm is secured to an examination table upon which the patient lays during treatment. The support arm includes one or more joints, which joints allow the scoop to be positioned at a desired location and angle relative the breast. The joints of the support arm are indexed and include markings which allow each joint to be independently “dialed in” to a specific position such that the breast support may be precisely repositioned to an exact orientation relative the breast when a patient is treated on successive occasions. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       A preferred embodiment of this invention has been chosen wherein: 
         FIG. 1  is a perspective view of the examination table with support arm attached; 
         FIG. 2  is a side view of one embodiment of the support arm; 
         FIG. 3  is a top view of the support arm of  FIG. 2  with scoop cut away; 
         FIG. 4  is a cross-section of the elbow of the support arm of  FIG. 2 ; and 
         FIG. 5  is a perspective view of one embodiment of the scoop. 
     
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENT 
     The present disclosure describes a support arm  10  extending between a mount  12  and a scoop  14  as shown in  FIG. 2 . Support arm  10  includes multiple points of articulation, including a lower joint  16 , an elbow  18  and an upper joint  20 . Each of joints  16 ,  18 ,  20  serve to allow hinged movement of support arm  10  such that scoop  14  may be positioned at a desired spatial orientation. 
     Scoop  14  defines a support surface  22 . Support surface  22  is bowl-shaped and forms the upper surface of scoop  14 . Support surface  22  is shaped such that it can be pressed against a breast  24  of a patient  26 , as shown in  FIG. 1 , such that support surface  22  supports and shapes breast  24  to a shape suitable for receiving a medical treatment, such as radiation. 
     Scoop  14  is carried on a scoop arm  28 . Scoop arm  28  defines an upper portion of support arm  10 . Scoop arm  28  extends between scoop  14  and upper joint  20 . Upper joint  20  is defined by a ball  30  and socket  32 . In one embodiment, socket  32  is a ball-shaped recess formed in scoop  14 . In another embodiment, as shown in  FIG. 2 , socket  32  is formed separately from scoop  14 . Ball  30  is rotatable in socket  32  such that scoop  14  may be positioned in a variety of spatial relationships relative to support arm  10  as needed to properly support breast  24 . Ball  30  includes markings, such as grid lines  34 , for repeatably orienting scoop  14 . In the preferred embodiment grid lines  34  are marked as latitude and longitude lines on ball  30 . Socket  32  includes an inner surface  36  (not shown) which contacts ball  30 . Socket  32  includes an outer surface  38  which includes markings  40  which serve to orient ball  30  in a repeatable spatial orientation with socket  32 . In the preferred embodiment, markings  40  are defined by a pair of spaced dots  44 ,  46  proximate an edge  42  of socket  32 . Markings  40  are repeatably alignable to a user-defined position  56  (not shown) on grid lines  34  by moving ball  30  relative socket  32  until first dot  44  is proximate a first latitude reading  48  (not shown) and a first longitude reading  50  (not shown) and second dot  46  is proximate a second latitude reading  52  (not shown) and a second longitude reading  54  (not shown). Ball  30  is rotatable relative socket  32  in three dimensions, meaning it is rotatable along an x, y, and z axis which passes through the center of ball  30 . Ball is retained at position  56  by tightening a fastener  58  which is carried on socket  32 . Fastener  58  is preferably formed having a knob  60  which, when rotated, advances or withdraws a threaded fastener member  58  from ball  30 , such that when fastener  58  is tightened against ball  30 , ball  30  will be held at position  56  relative socket  32 . In the preferred embodiment scoop arm  28  is joined to scoop  14  on one end and ball  30  on the other end. In an alternative embodiment scoop arm  28  is joined to scoop  14  on one end and to socket  32  on the other end. 
     Upper joint  20  is joined on one side to scoop arm  28  and is joined on another side to an upper arm  62 . In the preferred embodiment upper arm  62  is joined to socket  32  of upper joint  20 . Upper arm  62  extends between upper joint  20  on one end and elbow  18  on the other end. 
     Elbow  18  is a rotatable joint which allows rotation of upper arm  62  relative a lower arm  64  as shown in  FIGS. 2 and 4 . In the preferred embodiment, elbow  18  allows rotation of upper arm  62  relative lower arm  64  in a single plane. In an alternative embodiment, elbow  18  could be replaced by a different type of joint, such as a ball and socket type joint as described above. Elbow  18  is preferably formed from a pair of plates, an upper arm plate  66  and a lower arm plate  68 . Upper arm plate  66  is joined to upper arm  62 . Lower arm plate  68  is joined to lower arm  64 . Upper arm plate  66  is defined by a generally round outer edge  70  and a flat mating surface  72 . Lower arm plate  68  is defined by a generally round outer edge  74  and a flat mating surface  76 . Lower arm plate  68  is held against upper arm plate  66  such that mating surface  72  contacts mating surface  76 . A fastener  78  serves as the point of rotation between lower arm plate  68  and upper arm plate  66 . Fastener  78  may be tightened to hold upper arm plate  66  in a fixed position relative lower arm plate  68 . Alternatively, fastener  78  may be loosened to allow upper arm plate  66  to rotate relative lower arm plate  68 , in this way elbow  18  is rotatable to allow upper arm  62  and lower arm  64  to be aligned in a desired way to aid in positioning scoop  14  against breast  24 . Upper arm plate  66  includes markings  80  and lower arm plate  68  includes marking  82 , such that upper arm plate is rotatable relative lower arm plate to a position  84  (not shown) defined by a user. Markings  80  on upper arm plate  66  are preferably located on mating surface  72  at radially-spaced intervals, such that as lower arm plate  68  is rotated to position  84 , marking  82  will be proximate one of markings  80 , such that when fastener  78  is tightened, elbow  18  remains in that orientation. Position  84  is repeatable by realigning markings  80  and  82  at the user-defined position. 
     Lower arm  64  is joined at one end to elbow  18  and at the other end to lower joint  16 . Lower joint  16  is preferably formed from a ball  86  and a socket  88  having similar construction as the ball and socket joint described above. Lower joint  16  is joined to both lower arm  64  and a clamp arm  90 . In the preferred embodiment lower arm  64  is joined to ball  86  and clamp arm  90  is joined to socket  88 , such that lower arm  64  is rotatable relative clamp arm  90 . In an alternative embodiment, lower arm  64  is joined to socket  88  and clamp arm  90  is joined to ball  86 . Ball  86  includes markings  92 , such as latitude and longitude lines, similar to those described above, that can be repeatably located to markings  94  on socket  88 , such that lower arm  64  and clamp arm  90  may be repeatably oriented at a user-defined position  96  (not shown). A fastener  98  is carried by socket  88  and serves to brace ball  86  at position  96  when fastener  98  is tightened. 
     Clamp arm  90  is joined at one end to lower joint  16  and is joined at another end to mount  12 . Mount  12  is a clamp, or similar device suitable for mounting support arm  10  to a examination table  100  as shown in  FIG. 1 . The examination table of  FIG. 1  is merely illustrative of one table suitable for use with the support arm of the present disclosure. It is contemplated that support arm  10  is compatible with other tables or examination devices as are known in the art. Any reference to examination  10  should not be seen as limiting the application of support arm  10 . Instead, it is understood that support arm  10  is mounted to any structural support suitable for maintaining scoop  14  is a fixed position when wedged against a patient&#39;s breast. 
     In one embodiment examination table  100  includes a flange  102  extending from a side of the table, with flange  102  suitable for accepting mount  12 . Mount  12  is preferably positioned at a lateral position between the patient&#39;s breast and feet, preferably proximate the patient&#39;s navel. Flange  102  preferably extends for some length of table  100 , such that mount  12  may be secured at varying positions along flange  102 . In one embodiment, flange  102  includes markings  104  such that mount  12  may be moved to an indexed position along flange  102 , with the position identifiable by markings  104 . Mount  12  preferably includes a fastener  106  suitable for fastening mount  12  at a desired position on table  100 . In one embodiment, mount  12  is removably attached to table  100 , such that it is laterally movable to different positions relative table  100 . In another embodiment mount  12  is fixedly attached to table  100 , such that it is held at a fixed position on table  100 . 
     As described herein, each of joints  16 ,  18 ,  20  and flange  102  include markings for reproducibly orienting scoop  14 . These markings serve as an index and include identifiers, such as numbers, letters or other symbols, such that a given orientation of a joint will be identifiable by some combination of symbols. In this way, a user can orient scoop  14  against a patient&#39;s breast and then tighten each of the respective fasteners. With the fasteners thus tightened, the user records the indexed position of each joint by noting the symbols on each joint. In this way, when the patient returns for a follow-up visit, scoop  14  is positioned in the precise spatial arrangement as the previous visit by returning each joint to the previously-recorded indexed position, thereby allowing precise and repeatable application of a treatment or therapy on subsequent visits. 
     In one embodiment of the present invention, each of joints  16 ,  18 ,  20  and flange  102  include detents such that the respective joints/flange are positionable at discrete positions, which positions are reproducible by noting the respective markings. In the case of the ball and socket joints  16 ,  20 , the ball includes a series of raised or lowered dimples, similar to the surface of a golf ball, and the socket includes matching bosses or recesses for mating with the ball, such that as the ball is rotated within the socket the dimples and bosses/recesses mate at discrete positions and can then be clamped in place by the respective fastener. Elbow joint  18  may include radial detents which allow the elbow to be held at discrete angles when the fastener is tightened. Flange  102  also includes a series of detents extending perpendicularly to the length of the flange, which detents allow the clamp to be held specific positions along the flange. 
     Support arm  10  is designed with rigid parts, such that when joints  16 ,  18 ,  20  are locked by the respective fasteners, scoop  14  will provide sufficient force to deform and hold breast  24  in a desired shape. Preferably, scoop  14  is positioned such that breast  24  is held in a bulbous shape by being wedged against the base and side of the breast. 
     In an alternative embodiment (not shown), one or both of upper arm  62  or lower arm  64  is formed such that the length is extendible. In such embodiment, upper arm  62  is formed having an inner arm and a sleeve, with the inner arm carried within the sleeve in a telescoping arrangement. The inner arm is movable within sleeve  110  so as to lengthen or shorten upper arm  62 . The inner arm includes a series of markings extending axially along the inner arm, which markings are used to repeatably position upper arm  62  at a user-defined position. A fastener locks inner arm  108  and the sleeve at the desired position. A corresponding inner arm, sleeve, marking, and fastener configuration could be included for one or both of upper arm  62  and lower arm  64 . 
     Scoop  14  is preferably shaped to form breast  24  to a bulbous shape.  FIG. 5  shows a preferred shape of scoop  14 . A shown here, scoop  14  includes a lip  114  which forms the upper edge or rim of the scoop. In this embodiment, scoop  14  includes a pad  112  which covers a portion of lip  114  of scoop  14 . Lip  114  is cut-away, or recessed, where contacted by pad  112 . In this way, scoop  14  is positioned against breast  24  such that pad  112  contacts the patient near where the breast meets the chest proximate the arm of the patient, and support surface  22  forms the breast into the desired shape. Pad  112  is optional, but is provided in this embodiment to provide comfort to the patient.