title: Implementing the Prospective Surveillance Model (PSM) of Rehabilitation for Breast Cancer Patients with 1-Year Postoperative Follow-up, a Prospective, Observational Study.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Surgery, Emory University, Atlanta, GA, USA.|AVON Comprehensive Breast Center at Grady Memorial Hospital, Atlanta, GA, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Lai
authors.affiliation: Turning Point Breast Cancer Rehabilitation, Atlanta, GA, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Binkley
authors.affiliation: Department of Surgery, City of Hope National Medical Center, Duarte, USA.
authors.forename: Veronica
authors.initials: V
authors.lastname: Jones
authors.affiliation: Department of Radiation Oncology, Emory University, Atlanta, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kirkpatrick
authors.affiliation: Turning Point Breast Cancer Rehabilitation, Atlanta, GA, USA.
authors.forename: Cathy
authors.initials: C
authors.lastname: Furbish
authors.affiliation: School of Rehab Science, McMaster University, Hamilton, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Stratford
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, USA.
authors.forename: Winifred
authors.initials: W
authors.lastname: Thompson
authors.affiliation: Department of Family Medicine, University of Toledo, Toledo, USA.
authors.forename: Amanjyot
authors.initials: A
authors.lastname: Sidhu
authors.affiliation: Department of Surgery, Emory University, Atlanta, GA, USA.
authors.forename: Clara
authors.initials: C
authors.lastname: Farley
authors.affiliation: AVON Comprehensive Breast Center at Grady Memorial Hospital, Atlanta, GA, USA.|Department of Surgery, Morehouse School of Medicine, Atlanta, USA.
authors.forename: Joel
authors.initials: J
authors.lastname: Okoli
authors.affiliation: Department of Surgery, Morehouse School of Medicine, Atlanta, USA.
authors.forename: Derrick
authors.initials: D
authors.lastname: Beech
authors.affiliation: Department of Surgery, Emory University, Atlanta, GA, USA. sgabram@emory.edu.|AVON Comprehensive Breast Center at Grady Memorial Hospital, Atlanta, GA, USA. sgabram@emory.edu.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Gabram
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000628:therapy*; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D015412:Mastectomy, Segmental / Q000009:adverse effects; D008875:Middle Aged; D008962:Models, Theoretical; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D010147:Pain Measurement; D010353:Patient Education as Topic; D011159:Population Surveillance; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects; D034941:Upper Extremity / Q000503:physiopathology*