[Patient engagement in rehabilitation path after breast cancer surgery: costs impact. State-of-the-art and new perspectives.]

The Italian Association of Medical Oncology (AIOM) and the Italian Association of Cancer Registers (AIRTUM) highlight that one out of three women experiences cancer in the course of her life. In 2018, excluding skin cancers, breast cancer accounted for 14.1% of total cancers, confirming it as the most diagnosed cancer among women (29.3%). In the postoperative stage, patients suffer side effects. They need immediate and active rehabilitation to encourage their return to work as well as the psychological recovery. The effectiveness and speed of this recovery, therefore, have significant impact in the short and long term, also for the society. The rehabilitative oncology path increases its positive effects if carried out through co-productive pathways. The economic impact of this process is unclear. An exhaustive literature search was performed to shed light on state of the art about the patients' engagement during the rehabilitation path after breast cancer surgery, focusing on the literature analyzing the impact that co-productive processes can have on costs. Eligibility criteria: papers and reviews published in English and Italian were searched in Scopus and PubMed/Medline, among other datasets. dealing with economic effects resulting from patient engagement or following post-breast cancer oncology rehabilitation. 24 papers have been selected. The review of the literature has revealed a lack of contributions on the economic impact of the patient engagement in the oncological rehabilitation path, taking into account the impact on costs, but not developing a more detailed study. The back-to-work issue and psychological effects are widely investigated. No studies have been conducted in Italy. The analyzed literature did not identify the economic impact that patients' engagement may have during rehabilitation, opening up new research questions. Co-production processes are starting to develop.