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Life sciences · Journal article
Physical and Rehabilitation Medicine Medical Rehabilitation · September 29, 2026
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AIM: To study the frequency and structure of cardiorespiratory, neuromuscular, and nutritional impairments of functional reserve in patients with BC depending on the antitumor treatment regimen and to substantiate the need for a differentiated approach to medical rehabilitation. METHODS: A retrospective cohort study was conducted based on data from the electronic medical system of the Ivanovo Regional Oncology Dispensary for 2023–2025. All patients (n=891) had verified BC and received treatment according to current clinical guidelines. Patients were divided into four groups: Group 1: surgery + sentinel lymph node biopsy + radiation therapy ± hormonal therapy (n=234); Group 2: surgery with axillary lymph node dissection + radiation therapy ± hormonal therapy (n=203); Group 3: anthracycline-containing chemotherapy ± taxanes ± anti-HER2 therapy ± radiation therapy (n=354); Group 4: palliative care (n=99). Cardiorespiratory, neuromuscular, and nutritional outcomes were assessed. The χ² test with pairwise comparisons and Bonferroni correction was used to compare categorical variables between groups, and the Kruskal-Wallis test was used for quantitative variables. RESULTS: At least one impairment of functional reserve was identified in 571 patients (64.1%). The disorder profiles differed significantly between the groups (p0.001). In Group 2, lymphedema was the predominant complication (65.0%); in Group 3, cardiotoxicity (35.3%), neuropathy (15.3%), and nutritional disorders (44.4%); and in Group 4, nutritional depletion (19.2%), dyspepsia (37.4%), and mortality during follow-up (62.6%). Chemotherapy dose reductions were recorded in 15.8% of patients in Group 3 and 14.1% in Group 4. Based on the identified disorder profiles, a core set of disability domains in ICF categories was developed for each group. CONCLUSION: The anticancer treatment regimen defines a specific profile of functional reserve impairments, precluding the possibility of a single rehabilitation protocol for breast cancer. Systematization of impairments within ICF categories creates a structured basis for planning differentiated rehabilitation programs. The obtained data determine the direction of functional reserve, while the rehabilitation diagnosis remains individualized for each patient. The retrospective design and registry-based data source limit the completeness of impairment identification due to the lack of standardized rehabilitation tools; the single-center nature of the study limits the external validity of the results.