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Implementing the Prospective Surveillance Model (PSM) of Rehabilitation for Breast Cancer Patients with 1-Year Postoperative Follow-up, a Prospective, Observational Study

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The Prospective Surveillance Model (PSM) of rehabilitation for patients with breast cancer aims for early identification, treatment, and support of physical impairments postoperatively. The purpose of this study was to describe the incidence of impairments during the first postoperative year and the differences between the patients requiring rehabilitation intervention versus those not requiring intervention.

Methods

A total of 120 patients were enrolled. Impairment measures included: pain, range of motion, and self-reported measures of function using the Upper Extremity Functional Index (UEFI) and Quick Disability of the Arm, Shoulder and Hand (QuickDASH) questionnaires. These measures were performed at designated intervals during the first postoperative year. All patients received exercise and education, and patients with identified impairments underwent individualized rehabilitation intervention. Clinical factors associated with need for intervention were determined using univariate analysis.

Results

Thirty-six patients required rehabilitation intervention. There were no statistically significant differences between intervention and no-intervention groups for body mass index, breast surgery type, reconstruction type, or radiotherapy. Statistically significant differences were found between intervention and no-intervention groups in early postoperative UEFI, QuickDASH, pain scores, age, number of lymph nodes removed [9.3 (intervention) vs. 5.6 (no-intervention)], axillary surgery type, chemotherapy, and breast cancer stage.

Conclusions

Survivorship practitioners should have heightened awareness for rehabilitation intervention in patients with greater axillary surgery and burden of disease. Patients with more activity restriction and lower levels of function in the early postoperative period may benefit from rehabilitation intervention. Future studies should focus on implementing a screening tool to identify patients in need of rehabilitation referral.

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Acknowledgment

This study was funded by a grant from the Avon Foundation. We additionally acknowledge the Avon patient navigators, TurningPoint Breast Cancer Rehabilitation for donation of supplies and equipment, and medical student Austin Eckhoff for assistance with data collection.

Disclosure of any financial interest

None.

Author information

Authors and Affiliations

  1. Department of Surgery, Emory University, Atlanta, GA, USA

    Lisa Lai MD, Clara Farley MD & Sheryl Gabram MD, MBA

  2. AVON Comprehensive Breast Center at Grady Memorial Hospital, Atlanta, GA, USA

    Lisa Lai MD, Joel Okoli MD, MPH & Sheryl Gabram MD, MBA

  3. Turning Point Breast Cancer Rehabilitation, Atlanta, GA, USA

    Jill Binkley MSc, PT, CLT & Cathy Furbish PT

  4. Department of Surgery, City of Hope National Medical Center, Duarte, USA

    Veronica Jones MD

  5. Department of Radiation Oncology, Emory University, Atlanta, USA

    Stephanie Kirkpatrick PT, DPT, CLT

  6. School of Rehab Science, McMaster University, Hamilton, USA

    Paul Stratford PT, MS

  7. Rollins School of Public Health, Emory University, Atlanta, USA

    Winifred Thompson PhD, MSW

  8. Department of Family Medicine, University of Toledo, Toledo, USA

    Amanjyot Sidhu MBBS, MPH

  9. Department of Surgery, Morehouse School of Medicine, Atlanta, USA

    Joel Okoli MD, MPH & Derrick Beech MD

Authors
  1. Lisa Lai MD
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  2. Jill Binkley MSc, PT, CLT
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  3. Veronica Jones MD
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  4. Stephanie Kirkpatrick PT, DPT, CLT
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  5. Cathy Furbish PT
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  6. Paul Stratford PT, MS
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  7. Winifred Thompson PhD, MSW
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  8. Amanjyot Sidhu MBBS, MPH
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  9. Clara Farley MD
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  10. Joel Okoli MD, MPH
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  11. Derrick Beech MD
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  12. Sheryl Gabram MD, MBA
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Corresponding author

Correspondence to Sheryl Gabram MD, MBA.

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Lai, L., Binkley, J., Jones, V. et al. Implementing the Prospective Surveillance Model (PSM) of Rehabilitation for Breast Cancer Patients with 1-Year Postoperative Follow-up, a Prospective, Observational Study. Ann Surg Oncol 23, 3379–3384 (2016). https://doi.org/10.1245/s10434-016-5315-z

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  • DOI: https://doi.org/10.1245/s10434-016-5315-z

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