Hot off the press!

This month’s evidence update features a study published this week by TurningPoint and our research partners at The Avon Breast Center at Grady Hospital and Emory University.

The study examined the benefit of early identification and treatment of the physical side effects of breast cancer treatment, such as pain, limitation in motion and function and lymphedema (chronic arm swelling). Participants were 120 patients being treated for breast cancer at the Avon Breast Center at Grady Hospital. Grady is a safety net hospital in downtown Atlanta. Study participants were primarily underserved and minority women who would not typically be able to access this type of care.

Pain, range of motion, arm volume and function were evaluated by a physical therapist at designated intervals. These assessment intervals were: pre-op, early post-op (2-4 weeks), 6 weeks and 3, 6, 9 and 12 months after surgery. All patients received range of motion exercise and education. Patients with identified impairments such as significantly limited range of motion, axillary cording or lymphedema received more intense individualized rehabilitation. One third (36) of the patients required this more intense intervention. Sixteen patients developed lymphedema during the first post-operative year. In 12 patients, lymphedema was identified and treated early and managed at low levels (<10% greater than baseline measure). In just four patients, lymphedema progressed to more severe levels, defined in the study as 11% greater than baseline.

Of interest is that participants who needed more intense rehab intervention had significantly lower arm function and more pain in the early post-operative phase as well as more nodes removed and higher stage of breast cancer. This finding may help us to identify early which patients will require more intense rehabilitation and plan their care accordingly.

Our research team concluded that health care providers should have heightened awareness for rehabilitation intervention and that early identification and management of lymphedema, range of motion and functional issues appear to benefit breast cancer patients.

The work exemplifies TurningPoint’s commitment to evidence-based practice and reducing barriers to breast cancer rehabilitation and exercise.

Read the published study here.

Lai L, Binkley J, Jones V, Kirkpatrick S, Furbish C, Stratford P, Thompson W, Sidhu A, Farley C, Okoli J, Beech D and Gabram S. 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. 2016 Jun 22. [Epub ahead of print]