Prospective surveillance model can reduce treatment costs for breast cancer-related lymphedema

Model associated with significant cost savings

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

The study, led by APTA member and spokesperson Nicole Stout, PT, MPT, CLT-LANA, compared a prospective surveillance model with a traditional model of impairment-based care and examined the direct treatment costs associated with each program. Treatment and supply costs were estimated based on the Medicare 2009 physician fee schedule. Researchers estimated that treatment for breast cancer-related lymphedema costs $636.19 a year when the prospective surveillance model was used vs $3,124.92 for traditional treatment of advanced lymphedema.

The goal of a prospective surveillance model for cancer rehabilitation is to identify impairment at the earliest onset to alleviate impairment or prevent it from progressing. Soon after diagnosis, a physical therapist will perform a preoperative examination to establish a baseline level of function. Follow-up examinations are then conducted postoperatively at 1 month and then 3-month intervals, for up to 1 year. In contrast, a traditional model focuses on treating lymphedema once it has progressed and patients already 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.