Lydia Henderson, MD
Medical Resident
Shirley Ryan AbilityLab/Northwestern University
Chicago, Illinois, United States
Kathryn Abplanalp, MS, OT
Senior Occupational Therapist
Shirley Ryan AbilityLab
Chicago, Illinois, United States
Ishan Roy, MD, PhD
Physician Scientist/Assistant Professor
Shirley Ryan AbilityLab/Northwestern University
Chicago, Illinois, United States
Inpatient rehabilitation (IPR) is an important part of treatment for certain patients with breast cancer. However, little has been publicly reported regarding the medical prognosis of breast cancer patients in IPR. This study investigates the factors leading to admission to IPR in this population, and determine their influence on post-rehab survival.
Design:
This is an interim analysis of a retrospective cohort of 52 patients diagnosed with breast cancer who were admitted to an IPR facility between 2017 and 2021 under a cancer rehabilitation service. Data were extracted from the electronic health record in March 2024. Demographics, breast cancer characteristics, and reasons for IPR admission were first descriptively analyzed and then compared against mortality post-rehabilitation.
Results:
Among the cohort, 17 (32.7%) were admitted after treatment for a brain tumor, 9 (17.3%) for spinal cord injury (SCI), 7 (13.5%) for failure to thrive (FTT), and all others totaled 19 (36.5%). In total, 44 (84.6%) had metastatic cancer. Patients were admitted to IPR a median of 4 years after their initial cancer diagnosis. Those with central nervous system (CNS) involvement or FTT had higher odds of a primary physical impairment directly related to cancer (p=0.0007, OR 23.27), while others were frequently admitted for unrelated functional issues (e.g. orthopedic injury, gastrointestinal surgery). Mortality rate was 82.4% for those with brain tumor, 71.4% for failure to thrive, 77.8% for spinal cord injury, and 47.4% for others. All patients who died had metastatic cancer. Those with CNS involvement or FTT had significantly worse survival after IPR (median 5 months) compared to all others (median 28 months, p=0.0097).
Conclusions:
Breast cancer patients admitted to IPR overwhelmingly had metastatic disease, and those with CNS involvement or FTT died within six months of discharge. Goals of care for these patients may differ, and functional goals should match this clinical prognostic timeline.
