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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2016

01-10-2016 | Breast Oncology

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

Authors: Lisa Lai, MD, Jill Binkley, MSc, PT, CLT, Veronica Jones, MD, Stephanie Kirkpatrick, PT, DPT, CLT, Cathy Furbish, PT, Paul Stratford, PT, MS, Winifred Thompson, PhD, MSW, Amanjyot Sidhu, MBBS, MPH, Clara Farley, MD, Joel Okoli, MD, MPH, Derrick Beech, MD, Sheryl Gabram, MD, MBA

Published in: Annals of Surgical Oncology | Issue 10/2016

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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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Metadata
Title
Implementing the Prospective Surveillance Model (PSM) of Rehabilitation for Breast Cancer Patients with 1-Year Postoperative Follow-up, a Prospective, Observational Study
Authors
Lisa Lai, MD
Jill Binkley, MSc, PT, CLT
Veronica Jones, MD
Stephanie Kirkpatrick, PT, DPT, CLT
Cathy Furbish, PT
Paul Stratford, PT, MS
Winifred Thompson, PhD, MSW
Amanjyot Sidhu, MBBS, MPH
Clara Farley, MD
Joel Okoli, MD, MPH
Derrick Beech, MD
Sheryl Gabram, MD, MBA
Publication date
01-10-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 10/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5315-z

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