Inaugural Prospective Surveillance Model pilot in a Tertiary Hospital in WA.
Angela Barnett-moorcroft1 1Sir Charles Gairdener Hospital, Nedlands, WA, Australia
Abstract
Background: Breast Cancer is the most common cancer suffered by Australian women, with increasing survivorship. Outcomes and morbidity associations are well documented with lymphoedema being a notable treatment-related morbidity. In breast cancer, research has shown that regular surveillance of patients and early intervention if sub-clinical signs of oedema are detected, can change the trajectory of chronic oedema. During the recovery phase post-surgery, the lymphatic system undergoes compensatory, physiological changes, which, in the case of arm lymphoedema, early intervention may assist the prevention of permanent, irreversible upper limb (UL) lymphoedema. Aim: To design and implement a 2-year Prospective Surveillance Model of care (PSM) with early intervention for breast cancer patients within a tertiary hospital in Western Australia, with collaboration between Sir Charles Gairdner Hospital Breast Centre, Physiotherapy and Occupational Therapy departments. Method: All patients undergoing breast cancer related surgery with sentinel nodal sampling or node clearance were considered, between January 2021 and June 2022. Regular surveillance with data collection at 3, 6, 9 and 18 months was undertaken, in addition to standard practice which included pre-op and post-op assessment, 12- and 24-month assessment. Preliminary results: 378 patients were recruited; 13% of patients (50/378) triggered sub-clinical parameters for UL OT early intervention; 2.6% (10/378) progressed to Stage 1 or greater clinical lymphoedema. Conclusion: in the clinical environment of a tertiary hospital, significant reduction in incidence of progression to clinical lymphoedema was noted in preliminary findings within the PSM pilot.
Biography
Angela Barnett-Moorcroft is a senior clinical physiotherapist and accredited lymphoedema therapist working in SCGH Breast Centre. She has many years of clinical experience in cancer services, plastics and upper limb pathologies, working collaboratively with Occupational therapy colleagues.