Survivorship begins where treatment ends
Finishing treatment is a milestone, not a finish line. The evidence shows that the months and years afterwards need their own plan, one that treats rehabilitation as core care rather than something to arrange informally once everything else is done.
What long-term survivorship still needs
A systematic review of clinical practice guidelines for long-term breast cancer survivorship found most recommendations focus on prevention and surveillance, while gaps remain in lifestyle guidance and managing complications such as lymphoedema, osteoporosis and cognitive dysfunction [1] And that’s not even including the massive gap in mental health support when the medical team and regular appointments seem to disappear.
Care coordination and psychosocial interventions were found to be addressed inconsistently across guidelines, pointing to where survivorship care most needs strengthening
Keeping a record that follows the patient
A systematic review of survivorship care plans, comprising a treatment summary and a follow-up plan, found they were linked to improved survivorship knowledge, satisfaction with care and communication with providers [2]
Findings on measurable health outcomes were more variable, suggesting the value of a survivorship care plan lies as much in clarity and continuity as in any single clinical result
Exercise encouraged
Clinical guidance on long-term follow-up care now supports exercise, including resistance training, which was previously discouraged for breast cancer survivors [3]
This shift reflects a broader move towards treating physical activity as part of recovery rather than a risk to manage around
Preventing lymphoedema before it starts
A randomised trial of prospective surveillance and exercise in high-risk patients found the approach reduced arm volume and prevented breast cancer related lymphoedema, while also improving grip strength and overall physical performance [4]
The trial reported high safety and adherence, supporting the case for integrating this kind of surveillance into routine survivorship care
Building strength safely
A 2025 trial found resistance training was safe for breast cancer survivors at risk of lymphoedema, including those who had undergone mastectomy, adding to evidence that structured strength work does not carry the risk once assumed [5]
Increased muscle mass and contraction during resistance training is thought to support fluid return through the lymphatic system of the upper limb
Knowing who needs rehabilitation most
Researchers developed a risk assessment tool, ARM-BCT, that scores 17 factors, including mastectomy, axillary lymph node dissection and low physical activity, to identify patients at higher risk of arm morbidity after breast cancer treatment [6]
Categorising risk in this way is intended to support earlier, more targeted referrals to rehabilitation services rather than a uniform approach for everyone
Rehabilitation as core care, not an afterthought
A longitudinal analysis of physical therapy use after breast cancer surgery found rehabilitation needs to be reframed as a core component of survivorship care, delivered proactively rather than only when problems are already established [7]
The study called for this care to be delivered equitably, so that access does not depend on where or how a person happens to be treated
Support that fits around daily life
A structured home exercise programme for lymphoedema prevention and treatment, delivered by a multidisciplinary team, achieved significantly higher patient compliance than routine care alone [8]
Health coaching and personalised guidance were identified as factors that help survivors sustain exercise routines over the longer term
The long-term vision
The sector is working towards a future where survivorship care is proactive and personalised from the point treatment ends, not arranged informally once problems appear. The gap in mental health support is only now becoming recognised.
Frontier supports case for rehabilitation to meet survivors’ needs – covering both physical and mental health support.
Sentinel qCTC™ is an investigational technology platform undergoing development at Frontier Diagnostics Ltd. The platform has not reached design freeze and has not been submitted for regulatory review under IVDR (EU) 017/746, UK MDR 2002, or FDA 21 CFR Part 809. It is not approved, cleared, or validated for diagnostic, clinical, or commercial research use. All scientific content relating to Sentinel qCTC™ describes developmental aims and does not constitute performance claims.
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