Relevance: early breast cancer is detected in more than 60% of cases. Maintaining the quality of life of patients with early breast cancer at the highest possible level is a priority, along with the treatment of patients. Under a complex antitumor treatment as well as after its completion, more than 60% of patients with early breast cancer report the occurrence of functional disorders.An important aspect is to improve the effectiveness of the rehabilitation process of patients with early breast cancer taking into account scientifically-based and proven recommendations.Objective: to evaluate the event-free survival rate (EFS) of patients with EBC undergoing rehabilitation within a biopsychosocial approach.Materials and methods: 228 patients with breast cancer who received complex treatment from 2015 to 2019 were included in the study. The prospective part of the study included 114 patients with early breast cancer undergoing rehabilitation measures within the biopsychosocial approach. The control group which was selected retrospectively, using the method of "pairwise selection", included 114 patients with early breast cancer comparable in age, stage of the disease, volume of surgical treatment and menopausal status, undergoing physical and psychological rehabilitation prescribed by a doctor. Patients in both groups were stratified depending on preoperative chemotherapy. EFS was calculated over a 2-year follow-up period. Events that were censored were a disease progression, the appearance of metastases, the occurrence of another cancer, a new concomitant disease, an exacerbation of the concomitant pathology and death.Results: Rehabilitation measures within the biopsychosocial model improve the indicators of EFS in the group of patients with EBC: EFS was 18.3 months against 14.5 months in the control group (HR=0.91, 95% CI [0.83; 0.99]; p=0.0034). In a multi-factor analysis the key factors affecting EFS were neoadjuvant chemotherapy (HR=0.79, 95% CI [0.69; 0.94]; p=0.0025), age (HR=0.87, 95% CI [0.71;1.09]; p=0.0027) and menopausal status (HR=0.85, 95% CI [0.84; 0.95]; p=0.0022) (table 1). Conclusions: Rehabilitation measures within the biopsychosocial model improve the indicators of EFS in the group of patients with early breast cancer, the key factors affecting EFS were neoadjuvant chemotherapy, age and menopausal status. Table 1 Multi-factor analysis of event-free survival of patients with early breast cancer in the group of biopsychosocial model of rehabilitation versus control group.CharacteristicNumber of patientsHR (95% CI)Preoperative chemotherapyyes1520,84 (0,77; 1,1)no760,79 (0,69; 0,94)Menopauseyes1300,84 (0,77; 1,04)no980,85 (0,84; 0,95)Age group25-44610,87 (0,71; 1,09)45-601030,89 (0,74; 1,1)61-75641,01 (0,82; 1,24)EventDisease progression281,11 (0,86; 1,26)Exacerbation of the concomitant pathology160,83 (0,74; 0,96) Citation Format: Valeria Kluge, Tatiana Semiglazova, Petr Krivorotko, Elena Melnikova, Vladislav Semiglazov, Kristina Kondrateva, Svetlana Nazarova, Margarita Tynkasova, Bahtiyar Adhamov, Roman Pesotsky, Konstantin Zernov, Valentina Chulkova, Boris Kasparov, Denis Kovlen, Vladimir Semiglazov, Alexey Belyaev. Biopsychosocial approach in the rehabilitation of patients with early breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-62.

The article presents the results of a study of the biopsychosocial principle in the rehabilitation of patients with breast cancer. Aim. to assess the need for patients with operable breast cancer in rehabilitation measures at various stages of treatment. Results. when assessing the need for rehabilitation of patients with operable breast cancer, it was found that the need for rehabilitation measures in all patients increases in the postoperative period and persists for 12 months after the end of treatment. Special attention should be paid to the indicators of physical and social functioning in subgroups of patients who received neoadjuvant chemotherapy: increased fatigue, weight gain, unstable emotional background impose significant restrictions on the socio-role functioning of patients, reducing the quality of life and increasing the risks associated with the progression of the underlying disease, exacerbation of chronic diseases. Thus, patients who participated in the program of rehabilitation measures in the framework of the biopsychosocial approach showed the best performance after the end of treatment during the observation period: in the subgroup of patients receiving chemotherapy and rehabilitation in the framework of the biopsychosocial model, the dynamics of the recovery needs of the operation sought to average indicators by domain “b4552 Fatigue” – 21%, “b4551 Aerobic capacity “ – 18%, “d240 Handling stress and other psychological demands » – 39%, “b710 Mobility of joint functions “ – 29%, self-service (“d510 Washing”; “ d540 Dressing») – 21%, “b455 Exercise tolerance functions “ – 22%. In the subgroup of patients who received on-demand rehabilitation, there was an increase in the need for rehabilitation by domain: “d240 Handling stress and other psychological demands “ – 45%, “b4552 Fatigue” – 28%, self-service (“d510 Washing”; “ d540 Dressing») – 32%, b455 Exercise tolerance functions – 30%. Conclusion: The results of the study suggest a positive effect of rehabilitation measures on the functioning of patients with operable breast cancer.

Background: Alopecia is one of the most frequent adverse event of chemotherapy (CHT) in patients with breast cancer (BC). Alopecia causes many unpleasant feelings, as well as emotional disorders, including depression, especially in women Aim: to improve the quality of life among BC patients undergoing CHT. Materials and methods: alopecia prevention procedures were performed by the Cold Caps and Scalp Cooling Systems during various regimens of CHT for 180 BC patients. The mean age of the BC patients was 43 y.o. (from 21 to 73). The alopecia prevention procedure was performed during CHT and included 3 steps: 1. The preventive cooling cycle took 20-30 minutes to achieve required temperature before proceeding medications. 2. The cooling cycle last during whole CHT. 3. The cooling cycle were continued after CHT and took from 60 to 120 minutes. The duration of post-CHT cycle was dependent on the type of drug and the period of excretion. Patients received various regimens of CHT, including: antracyclins (47%), taxanes (32%), Cisplatin (5%), Gemcitabine (3,5%), AT (3,5%), CP (9%). Local hypothermia during various regimens of CHT (n= 988). Regimens of CHTPatients, n=180Cycles, n= 988n cycles per patientАT (doxorubicin + paclitaxel)6355 (2-6)АС (doxorubicin + cyclophosphamide)864474 (2-6)СР (Carboplatin+ Paclitaxel)15201 (1-4)Paclitaxel584407 (4-12)Cisplatin9302 (2-4)Gemcitabine6162 (2-4) Alopecia degree evaluated based on СТСАЕ 4.0: I degree - hair loss of <50% of normal for that individual that is not obvious from a distance but only on close inspection; a different hair style may be required to cover the hair loss but it does not require a wig or hair piece to camouflage. II degree - hair loss of >=50% normal for that individual that is readily apparent to others; a wig or hair piece is necessary if the patient desires to completely camouflage the hair loss; associated with psychosocial impact. Results: Among BC patients who were given antracyclins (n=86), 62 (72%) had I degree alopecia, 24 (28%) - II degree alopecia. Among patients who were given taxanes (n=58), 56 (96%) suffered from I degree alopecia, in 2 (4%) of them developed II degree alopecia. Patients who received treatment with Cisplatin (n=9), 7 (78%) of them had I degree alopecia and 2 - II degree alopecia (22%); patients with gemcitabine-based CHT (n=6), suffered from I degree alopecia in 100%. Patients with AT (n=6), had I degree alopecia in 3 (50%) patients, 3 (50%) suffered from II degree alopecia. In regimens like CP (n=15), 8 (53%) had I degree alopecia, 7 (47%) - II degree alopecia. Side effects after procedure: 5 (2,8%) patients had headaches, procedure was discontinued for 3 (1,7%) patients because of intolerance to low temperatures. Conclusions: hypothermia of the hairy part of the head is an effective method of preventing alopecia among BC patients during chemotherapy with antracyclins (72% of cases), taxanes (96%), Cisplatin (78%) and with gemcitabine (100%). Citation Format: Veronika Klimenko, Tatiana Semiglazova, Boris Kasparov, Anton Krutov, Margarita Zernova, Kristina Kondrateva, Valeria Kluge, Evgenia Kharchenko, Artem Poltoratsky, Karina Khidishyan, Vladislav Semiglazov, Roman Donskih, Petr Krivorotko, Vladimir Semiglazov, Aleksey Belyaev. Preventing alopecia caused by chemotherapy among patients with breast cancer efficacy of applying the cooling hood [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-14-23.

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