Abstract PS5-10-16: Physical Therapy and Oncology Rehabilitation Referral and Enrollment Patterns among Breast Cancer Patients

Abstract Background: Supervised exercise interventions improve disease-specific and overall survival in colon cancer and may offer similar benefits in breast cancer (BC), with prior research demonstrating improvements in chemotherapy-related side effects, cardiorespiratory fitness and quality of life. Oncology rehabilitation (OR) offers supervised and tailored exercise interventions and are routinely available to BC patients via physical therapy (PT) referral, however these programs may be underutilized. We sought to characterize patterns of PT/OR referral, utilization, and clinical benefit among BC patients. Methods: A retrospective cross-sectional analysis of 53,972 BC patients seen within the Providence St. Joseph Health System between October 2015 and March 2025 was performed. Data were abstracted from patient electronic health records, and descriptive statistics were performed to summarize baseline characteristics of the participants. Random-intercept multilevel logistic regression models, including region/hospital as a random effect, were used to assess predictors of PT/OR referral and enrollment. Baseline and Follow-up exercise tests assessing cardiorespiratory fitness (VO2max) were used to assess the clinical benefit of PT/OR. Results: Comparisons between BC patients that were referred to and enrolled in PT/OR versus not are provided in the table. Forty-one percent of the overall study population was referred (n=22,061) to PT. In multivariate analysis, significant predictors of PT referral included younger age (odds ratio: 0.99 [95% CI: 0.99 - 1.00]), higher BMI (odds ratio: 1.01 [95% CI: 1.01 - 1.02]), hypercholesterolemia (Odds ratio: 1.45 [95% CI: 1.33 - 1.58]), and receipt of chemotherapy (Odds ratio: 1.61 [95%CI: 1.47-1.77]). Among those referred, 13,059 (59%) enrolled and participated. Enrolled patients attended an average of 16 ± 15 appointments, with 25% attending ≥ 20 sessions. 2,051 patients (16%) underwent an exercise test, predicted by older age (Odds ratio: 1.03, 95% CI: 1.02 - 1.03) and higher BMI (Odds ratio: 1.03, 95% CI: 1.02 - 1.04). The average baseline VO2max was 14.1 ± 3.6 ml/kg/min. PT/OR participants experienced improvements in VO2max (0.8 ± 2.8), with those attending ≥ 20 sessions experiencing greater benefit (1.2 ± 3.7 ml/kg/min) compared to those attending <20 sessions (0.7± 2.2 ml/kg/min). Conclusion: OR is routinely available via PT referral but uncommonly utilized by BC patients. However, it may be an effective and feasible strategy to improve physical fitness, quality of life, and potentially clinical outcomes. Citation Format: M. Imboden, H. Li, E. Koltner, C. Murphy, M. Layoun, D. Page. Physical Therapy and Oncology Rehabilitation Referral and Enrollment Patterns among Breast Cancer Patients [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-10-16