New Breast Cancer Treatment Model Emerging as Standard of Care

A physical therapist can significantly reduce costs and the need for intensive rehabilitation by diagnosing and treating breast cancer-related lymphedema early, according to an article published in the January issue of Physical Therapy, the scientific journal of the American Physical Therapy Association (APTA).

The study, led by APTA member and spokesperson Nicole Stout, PT, MPT, CLT-LANA, investigated the direct treatment costs associated with a prospective surveillance model and a traditional model of impairment-based care. The Medicare 2009 physician fee schedule was used to estimate the treatment and supply costs. According to researchers, the treatment for breast cancer-related lymphedema costs an estimated $636.19 per year with the prospective surveillance model and an estimated $3,124.92 with traditional treatment of advanced lymphedema.

With a prospective surveillance model, the goal for cancer rehabilitation is to detect impairment early to alleviate impairment or prevent its progression. Therefore, soon after diagnosis, a physical therapist completes a preoperative examination, and a baseline level of function is established. Postoperative follow-up examinations are performed at 1 month and then 3-month intervals, for up to 1 year. Conversely, goals of a traditional model focus on treating lymphedema that has progressed and caused patients to have functional limitations.

“This study begins to paint a picture of evidence showing that prevention of chronic conditions such as lymphedema – using rehabilitation models of care – may result in significant cost savings,” said Stout.

In place for more than 10 years, the prospective surveillance model is the standard of care for all patients diagnosed with breast cancer at the National Naval Medical Center in Bethesda (now part of the Walter Reed National Military Medical Center), where the model was developed.

Source: American Physical Therapy Association.