A breast cancer diagnosis is often described as the start of treatment. In reality, it is the start of something else first, a period of preparation called prehabilitation, which shapes how treatment unfolds and how people experience it.
What prehabilitation means
- Macmillan Cancer Support defines prehabilitation as a needs-based intervention, delivered before and during cancer treatment, aimed at optimising a person’s physical, nutritional and psychological health ahead of what lies ahead.[1]
- It is part of care, and it continues once treatment begins.
Why patients are assessed before treatment
- NICE guidance states that recommendations on systemic therapy should be based on multidisciplinary team assessment of prognostic and predictive factors, with the final decision made together with the patient. [2]
- Oncologists, surgeons, radiologists and specialist nurses review the same information as a group, allowing a plan to be personalised rather than standardised.
Physical preparation
- A qualitative study of patients and clinicians found prehabilitation before cancer surgery was broadly acceptable, supporting recovery and a sense of preparedness ahead of treatment. [3]
- Nutrition and activity are core components, helping people tolerate treatment and recover more fully afterwards.
Psychological preparation
- A 2025 study following newly diagnosed breast cancer patients found most of those with low distress at diagnosis did not go on to develop significant psychological symptoms later. [4]
- This suggests screening for distress at diagnosis is a meaningful opportunity to identify who may need extra support early.
Understanding tumour biology
- Not all breast cancers behave the same way; biomarker-driven approaches are central to matching patients with the most suitable treatment [5]
- This biological understanding is gathered before treatment decisions are finalised.
Why biomarkers matter
- Breast cancer cells are tested for biomarkers such as hormone receptors and HER2, information used to help shape the treatment plan [6]
- Shared decision making
- A systematic review found shared decision making is considered a keystone of high-quality breast cancer care, particularly where treatment options carry similar potential but different trade-offs. [7]
- Decisions are made with the person, not for them.
How precision oncology begins before therapy
- Precision medicine uses information about a person’s genes, proteins and other factors to guide decisions on prevention, diagnosis and treatment. [8]
- Its foundations are laid earlier than many expect, in the assessment and biological understanding gathered during prehabilitation.
The long-term vision
- The long term vision is a future where increasingly personalised pathways are supported by better information at every stage, from diagnosis through to long-term monitoring.
- Sentinel qCTC™ might be part of that long-term vision as a tool to add another piece of the jigsaw of valuable information – one day?
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) 2017/746, 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.
Sources
[1] Macmillan Cancer Support, Prehabilitation: transforming cancer care before treatment begins
[2] NICE, Early and locally advanced breast cancer: diagnosis and management (NG101)
[3] Powell, R. et al. (2023), Acceptability of prehabilitation for cancer surgery, BMC Cancer
[4] Langballe, R. et al. (2025), Are breast cancer patients with low distress at diagnosis at risk of psychological symptoms later?, Acta Oncologica
[5] Evolving Management of Breast Cancer in the Era of Predictive Biomarkers and Precision Medicine (2024), MDPI, Journal of Personalised Medicine
