Identify patient and triage according to current symptoms

1. Identify patient and triage according to current symptoms Needs specialized evaluation Needs no special evaluation Recent Time since diagnosis Distant Education: risk reduction for treatment-related morbidities, uptake and/or maintenance of healthy lifestyle behaviors High level of provision Education Low level of provision More frequent Less frequent Frequency of prospective surveillance for treatment morbidities Evaluation and Prospective surveillance: evaluation of baseline health and fitness and commencement of prospective surveillance of treatment-related morbidities amenable to efficacious interventions (e.g., lymphedema, fatigue, cardiovarscular disease late effect) Exercise Prescription Community-based exercise Appropriate exercise setting Medical-based rehabilitation ExercisePrescription: individualized based on woman’s knowledge (related to education) and previous exercise history and outcomes from evaluation and prospective surveillance Community fitness trainer Appropriate training of professional prescribing exercise Allied health professionals (e.g., PT, OT, Clinical exercise physiologist Every session supervised Appropriate level of exercise supervision Unsupervised Referral to specific allied health professional for evaluation and treatment as needed Needs no further special evaluation Unstable, complicated and/or multiple Presence of morbidities None, generally healthy Figure 1. Proposed breast cancer rehabilitation model which integrates surveillance, prevention education and management of treatment-associated morbidity and exercise prescription