Who is the PROSPER programme for?

The PROSPER programme has been developed for women who are more likely to develop shoulder problems following non-reconstructive surgery for breast cancer.

Research suggests the following procedures make it more likely to develop shoulder problems after breast cancer treatment:

• Axillary node clearance (ANC)

• Radiotherapy to the axilla and/or supraclavicular area

Women who have existing shoulder problems or are clinically obese (BMI >30) are also at risk of developing shoulder problems post treatment.

We tested the PROSPER programme in this population. We will tell you about the PROSPER Trial in step 1.10. Women aged 18 years or over, considered to be high risk of developing shoulder problems were invited to take part in the study before their breast cancer surgery (non-reconstructive).

It is important to note that certain patients were excluded from the trial. We excluded men from the trial. We also excluded women having bilateral breast surgery and those having immediate reconstructive surgery because their treatment pathways are different.

Women only having a sentinel lymph node biopsy (SLNB), regardless of their breast surgery, were excluded UNLESS they also met other ‘high-risk’ criteria e.g. high body mass index or existing shoulder conditions.

Finally, those with known metastatic disease at the time of recruitment were not eligible to take part.

We often get asked if the PROSPER programme is suitable for patients that are different to those in the trial.

The PROSPER programme may be beneficial for women not identified as high risk of shoulder problems or for men undergoing similar procedures. Clinicians need to use their clinical judgement whether to offer the PROSPER programme but we did not assess the benefit of the PROSPER programme in these patients. Therefore, we do not know if it would benefit these patients.

If your patient has undergone immediate reconstructive surgery then you need to consult with their surgeon about the appropriate post-operative rehabilitation protocol.