Aims: The Quality of Cancer Survivorship Care Framework outlines five domains of cancer survivorship care: 1) Prevention and surveillance for recurrences and new cancers 2) Surveillance and management of physical effects; 3) Surveillance and management of psychological effects; 4) Surveillance and management of chronic medical conditions; and 5) Health promotion and disease prevention. Given the global prevalence of breast cancer survivors, we aimed to apply this Framework to assess the evidence base supporting quality survivorship care in breast cancer, and identify priorities for implementation in clinical care, research, and policy.
Method: A systematic search was conducted (MEDLINE; Embase; CINAHL; PsycINFO; Scopus; Cochrane Library) for terms relating to breast cancer; survivors; and quality of life, side effects, surveillance, healthy lifestyle, or care coordination. Dual screening and extraction identified systematic reviews or meta-analyses of survivorship care interventions that included breast cancer survivors. Non-systematic reviews, primary research, opinions, and reviews reporting outcomes for anti-cancer treatments only were excluded. Included systematic reviews/meta-analyses were categorised according to Quality of Cancer Survivorship Care Framework domains.
Results: Of 6594 deduplicated records identified, 696 were retained for full text screening and 290 were eligible for data extraction. Systematic reviews/meta-analyses most frequently addressed the domains of surveillance and management of physical effects (N=155) and surveillance and management of psychosocial effects (N=138). Fewer studies addressed health promotion and disease prevention (N=68), prevention and surveillance of recurrence and new cancers (N=12), or surveillance and management of chronic medical conditions (N=5).
Conclusions: While ample research investigates surveillance and management of physical and psychological effects of breast cancer, far fewer high-level reviews summarise interventions addressing recurrence, new cancers, or chronic medical conditions. Efforts are needed to implement proven interventions while research and policy should be directed at neglected areas in order to improve outcomes for the increasing number of breast cancer survivors.