Effect of Telerehabilitation and Outpatient Rehabilitation in Women with Breast Cancer

Abstract

Telemedicine was shown to be indispensable during the SARS-CoV-2 pandemic to ensure continuity of care for fragile patients. We compared a telerehabilitation program versus an outpatient rehabilitation program in women with breast cancer undergoing quadrantectomy surgery. There were 56 women with breast cancer divided into two groups: the treatment group (TG), made up of 24 patients undergoing a remote rehabilitation project program; and the control group (CG), composed of 32 patients subjected to the same rehabilitation project program in an outpatient setting. At the time of enrollment (T0) and the end of the 8 weeks of treatment (T1), the following questionnaire scores were considered: numerical rating scale (NRS), Disabilities of the Arm, Shoulder and Hand questionnaire (Quick-DASH), Piper fatigue scale (PFS)m and Breast Cancer Therapy Functional Rating Scale (FACT-B).We observed that the CG showed greater improvements than the TG in upper limb function (7.8 4.2 vs. 10.9 4.9; p < 0.05) and quality of life (27.9 7.2 vs. 40.0 3.3; p < 0.05). No difference in efficacy between the two groups was observed for pain (2.2 0.6 vs. 2.3 0.9; p = 0.64) and fatigue (3.2 1.1 vs. 3.2 0.6; p = 0.66). Telerehabilitation is a valid tool in the management of women with breast cancer in the postoperative phase. However, face-to-face rehabilitation treatment may be preferred because it is more effective as it allows the construction of a specific, personalized, and targeted rehabilitation program. In some cases, before surgery, radiological investigations are performed to confirm that the disease is only localized in the breast and has not affected the axillary lymph node stations (lymphoscintigraphy). The subsequent surgical treatment checks the status of the lymph nodes in the ipsilateral axillary cavity and reveals the extent of the tumor and its characteristics, helping to define the therapeutic program. The most-used techniques for this purpose are sentinel lymph node biopsy (removal of only the lymph node closest to the tumor) and axillary dissection (removal of all lymph nodes).