Stakeholder perspectives on dissemination and implementation of a prospective surveillance model of rehabilitation for breast cancer treatment§††‡‡


  • The articles in this supplement were commissioned based on presentations and deliberations at a Roundtable Meeting on a Prospective Model of Care for Breast Cancer Rehabilitation, held February 24-25, 2011, at the American Cancer Society National Home Office in Atlanta, Georgia.

  • Stakeholder representatives: Michael D. Stubblefield, MD (American Academy of Physical Medicine and Rehabilitation); Wendy Demark-Wahnefried, PhD, RD, Christy Russell, MD (American Cancer Society); Anna Schwartz, FNP, PhD (American College of Sports Medicine and YMCA of the USA); Rosanne Iacono, RNC, MSN, CRNP (American College of Surgeons Commission on Cancer and National Accreditation Program for Breast Centers); Jane M. Armer, PhD, RN and Marcia S. Beck, ACNS, BC, CLT-LANA (American Lymphedema Framework Project); Jennifer Hughes, OTR (American Occupational Therapy Association); Ken Harwood, PT, PhD, CIE (American Physical Therapy Association); James L. Khatcheressian, MD (American Society of Clinical Oncology); Claire Nixon and Jamie DePolo (BREASTCANCER.ORG); Brandy L. Peaker, MD, MPH and Lori A. (Loria) Pollack, MD, MPH (Centers for Disease Control and Prevention); Haley Justice-Gardiner, MPH, CHES (LiveStrong); Valerie Kraus, PT, MS, CLT (Living Beyond Breast Cancer); Catherine M. Alfano, PhD (National Cancer Institute Office of Cancer Survivorship); Nancy A. Hutchison, MD, CLT-LANA (National Lymphedema Network); Deborah K. Mayer, PhD, RN, AOCN (Oncology Nursing Society); Diana Rowden (Susan G. Komen for the Cure); Ann-Hilary Heston (YMCA of the USA); and David S. Zucker, MD, PhD. Invited but unable to attend: American Society for Radiation Oncology, American Society of Plastic Surgeons, Avon Foundation for Women, Centers for Medicare and Medicaid Services, National Comprehensive Cancer Network, Society of Surgical Oncology, and Young Survival Coalition. American Cancer Society staff: Colleen Doyle, MS, RD; Katherine Sharpe, MTS; Tenbroeck Smith, Kevin Stein, PhD; and Marcia Watts.

  • §

    The views expressed in this article are solely those of the authors and are not necessarily reflective of the official policies or positions of the Department of Navy, Department of Defense, or the United States Government.

  • The opinions or views expressed in this supplement are those of the authors and do not necessarily reflect the opinions or recommendations of the editors or the American Cancer Society.

  • This article is US Government work and, as such, is in the public domain in the United States of America.

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    A Prospective Surveillance Model for Rehabilitation for Women with Breast Cancer, Supplement to Cancer

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    Re-use of this article is permitted in accordance with the Terms and Conditions set out at


The prospective surveillance model proposes a paradigm shift in the delivery of care for patients with breast cancer. The model is based on clinical research and clinical practice experience that was reviewed and discussed at a multidisciplinary meeting. The model identifies critical physical sequelae of treatment as well as timeframes for identification of and surveillance for these issues. Although the model of ongoing assessment for physical impairment and early rehabilitative intervention creates a framework for care, broad support and active dissemination among a variety of stakeholders will be required to transform patient care. Translating research findings to transform practice often occurs on a protracted timeline. The authors sought participation from a variety of stakeholder representatives throughout the process of creating this model in an effort to ensure that it reflects the realities of the patient experience and care delivery, to incorporate their input regarding the construct and viability of the model, and to potentiate effective and efficient strategies for implementation. This article summarizes comments from stakeholder representatives concerning the prospective surveillance model for rehabilitation for women treated for breast cancer. Concerns addressed include the scope of impairments included in the model, the potential creation of barriers to exercise and participation in community exercise programs, and cost and feasibility issues. Stakeholder disseminations strategies are also presented. Overall, there is recognition by the stakeholder group that this model calls attention to important unmet needs and defines a crucial opportunity to improve care for breast cancer survivors. Cancer 2012;118(8 suppl):. © 2012 American Cancer Society.