It's definately possible. The easiest way to tackle this is import a reference dataset into the existing Freehand map using MAPublisher. Set it to the same scale and projection as the original map, then move the original layers (*not* the reference layer) so that they match up.
Now you can transfer the georeference ("Map Defaults" I think that was called in MP 5 / Freehand, long time ago since I last used that), then "register" the data layers with MAPublisher ("Assign Area/Line/Point Defaults") and, if applicable, add attributes. Once that's completed, you can export it to a shapefile or mid/mif.
The accuracy that you can achieve is basically limited to how accurate you can position the existing map over the reference map.
It's a bit of an involved process, but I've done it numerous times in the past (though mainly with the Illustrator version of MAPublisher).
Hope this helps. If you have any more questions, I'd be happy to answer them.
Let's see if I understand this.
A. Original Freehand file
B. Reference file (simple graticule/coast/drainage layer file) with the same scale & projection parameters as original file in a GIS format (Shape/MIDMIF)
C. MAPublisher 5 for Freehand
1) Open the original file in Freehand
2) Load into this file the reference file using a tool in MAPublisher
3) Lock the layers for the reference file
4) Reposition, scale, rotate the original file layers to match the reference file
5) Then using a MAPublisher tool specify that the layers from the original file are now 'geo-layers'
6) Export in your favourite GIS format
Thanks Hans (informative just like in the FMETalk forum !)