Dr.Giordana Di Mauro

Abstract

Introduction/Objectives:
Integrative medicine is an increasingly important component of modern oncology care, focusing not only on cancer treatment itself but also on patients’ quality of life and overall well-being. Breast cancer survivors often experience long-term physical and psychosocial sequelae, including upper limb dysfunction, lymphedema, chronic pain, psychological distress, and reduced quality of life (QoL). Increasing evidence supports the role of integrative and multidisciplinary rehabilitation programs in addressing these unmet needs. The Italian Progetto Nastro Rosa was developed as a nationwide integrative rehabilitation initiative aimed at providing comprehensive care to women treated for breast cancer across different disease phases.
Methods:
This ongoing multicenter rehabilitation project includes women who have undergone surgery for breast cancer, including patients in follow-up, receiving adjuvant or endocrine therapy, and patients with metastatic disease. The program integrates structured physical activity—specifically fencing training—nutritional counseling, and psychological support within a non-hospital, gym-based setting. Fencing was selected for its potential benefits in upper limb rehabilitation, reduction of lymphedema, pain control, and functional recovery of the operated arm. Nutritional assessment focuses on adherence to the Mediterranean diet and healthy lifestyle promotion, while psychological support aims to enhance coping strategies and emotional well-being. Recruitment started in November 2025, with official project initiation in February 2026. Eight centers across Northern, Central, and Southern Italy are currently involved. At baseline (T0), participants undergo standardized assessments including the DASH questionnaire, Lymphedema Scale, EORTC QLQ-C30, MEDAS, and ULLS-30. These evaluations will be repeated at follow-up (T1) to assess changes in physical function, QoL, psychological status, and lifestyle adherence.
Results:
To date, 44 patients have been enrolled nationwide. Preliminary analyses on the first 18 patients showed a significant improvement in upper limb function and disability after the intervention. Mean DASH scores decreased from 37.5 at baseline to 19.8 at follow-up while the DASH Work/Sport module improved from 40.1to 21.4 (p < 0.001). A statistically significant improvement in quality of life (p < 0.001) and adherence to the Mediterranean diet was also observed.
These findings suggest reduced disability, fewer difficulties in daily activities, improved upper limb functionality, and better performance in work- and sport-related activities. High adherence to the program and excellent patient engagement were also observed.
Conclusions:
The Nastro Rosa Project represents an innovative, integrative, and patient-centered rehabilitation model for breast cancer survivors. The high level of participation highlights the importance of a holistic, 360-degree approach to oncology care beyond the hospital setting. Integrative medicine, combining adapted physical activity, psychological support, and nutritional counseling, may play a key role in the comprehensive management of treatment-related side effects and in the global care of patients beyond the oncological disease itself. Preliminary findings suggest that multidisciplinary rehabilitation programs may improve functional recovery, quality of life, patient empowerment, and overall psychosomatic well-being. Ongoing data collection will further clarify the clinical impact of this approach and support its broader implementation in integrative oncology care pathways.

Biography

Giordana Di Mauro was born in Catania, Italy, on October 20, 1996. She graduated in Medicine and Surgery with honors (110/110 cum laude) from the University of Catania and is currently a fifth-year resident in Medical Oncology at the University of Messina, with board certification expected in November 2026.
She is also attending the second year of her PhD program in Translational Molecular Medicine and Surgery at the University of Messina, where her research project focuses on the correlation between microbiota and colorectal cancer. During her training, she developed a particular interest in breast and gastrointestinal cancers, with special attention to integrative medicine.
She currently works at Policlinico G. Martino in Messina, where she is involved in both patient care and the Integrative Oncology and Nutrition outpatient clinic. In July, she will attend a training period at the Gemelli University Hospital in Rome within the Integrative Medicine Unit. Her scientific research activity is mainly focused on mycotherapy, adapted physical activity, lifestyle interventions, vitamin supplementation, and microbiota in oncology patients.
She received an award for research in integrative medicine for the project entitled: “Integrative multidisciplinary oncological approach with mycotherapy in metastatic cancer patients receiving oncological treatments: six clinical cases and literature review.”