Authors (including presenting author) :
Kwong CKK(1), Sheung RLM(2), Ng AFT(1), Chan SML(1), Chan SSL(1), Sham KPK(1), Tse ATK(1), Ling JWY(1), Leung CYY(1)
Affiliation :
(1) Physiotherapy Department, Princess Margaret Hospital
(2) Department of Surgery, Princess Margaret Hospital
Introduction :
In 2021, the Hong Kong Cancer Registry recorded 5,565 new female breast cancer cases. At Princess Margaret Hospital (PMH), around 200 new breast cancer cases were diagnosed recently. From 2017 to 2022, 1,920 female breast cancer patients were referred to physiotherapy outpatient rehabilitation at PMH, with 60% referrals from Surgical Specialty and 40% from Oncology Specialty.
Due to limited surgical beds, patients often miss consistent pre- and post-operative physiotherapy assessments, treatments, and education. To enhance services, a Comprehensive Breast Cancer Rehabilitation Program was implemented in August 2024, collaborating with the Department of Surgery and Outpatient Physiotherapy. This program aims to minimize complications and promote rehabilitation outcomes by providing pre- and post-operative assessments and training.
Objectives :
The program addresses the service gap for breast cancer patients scheduled for surgery in public or private hospitals who do not receive pre-operative physiotherapy. The study compares referral patterns and profiles before and after the program's implementation.
Methodology :
This retrospective cohort study analyzed outpatient physiotherapy referrals for the "CA Breast Rehabilitation Program." Data from April to July were compared to referrals from August to November 2024.
Result & Outcome :
From April to July, 112 new cases were referred to the program, with 105 attending—94% of whom showed up for the initial appointment. Only 2% were referred for pre-operative physiotherapy, while 98% were for post-operative treatment. Half were referred within three months after surgery for shoulder joint issues, scar care, and postural advice; the other half were referred more than three months after surgery, with 22% for joint care and reconditioning, and 33% for lymphedema management.
From August to November, 142 new cases were referred, with 126 attending—89% for the initial appointment. 37% were referred for pre-operative physiotherapy, and 91% of these received assessment, treatment, and education. 63% were referred for post-operative treatment, with 59% within three months post-surgery. 16% were referred for lymphedema management.
Post-operative complications with physiotherapy referrals totaled 35 from April to July, predominantly for shoulder issues. After the program's implementation, this reduced to 20 cases, with an equal number complaining of lymphedema and shoulder joint problems. Shifting service focus from post-operative to pre-operative phases facilitates earlier prevention of complications and the importance of pre-operative physiotherapy. Further investigation into rehabilitation outcomes is recommended.
