Research AppraisalSystematic Review

Beyond breast cancer: mapping unmet needs and advancing an evidence-based framework of survivorship care

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in CancerSilva, Amina, Dupuis, Kendra-Lee, Pourrajabi, Aseme et al.15 Apr 2026DOI

Clinical Snapshot

75CEBM
Evidence: ModerateSystematic Review

PICO Framework

P — PopulationBreast cancer survivors (BCS) who have completed active treatment
I — InterventionSystematic mapping of unmet needs and development of evidence-based survivorship care framework
C — ComparatorNot applicable (scoping review methodology)
O — OutcomesCategories of unmet needs, prevalence of needs domains, and proposed three-phase survivorship care framework

Bottom Line

This scoping review of 170 studies identifies six key domains of unmet needs among breast cancer survivors, with physical symptoms and psychosocial concerns being most prevalent. The proposed three-phase framework—universal screening, targeted interventions, and ongoing evaluation—offers a structured approach to survivorship care. While the comprehensive mapping provides valuable insights, the framework requires validation studies and implementation research. Australian clinicians should consider these findings when developing survivorship care plans, particularly addressing the high prevalence of chronic physical symptoms and persistent psychosocial distress. The framework aligns with current Australian cancer care standards but needs adaptation for local healthcare contexts and resource constraints.

Evidence: Moderate

Key Findings

  • P Value: Not applicable for scoping review

  • Effect Size: Physical symptoms reported in 33.5% of studies, psychosocial/emotional needs in 32.4%

  • Primary Outcome: Six categories of unmet needs identified across breast cancer survivors

  • Nnt Or Sensitivity: Framework sensitivity for identifying unmet needs not quantified

  • Confidence Interval: Not reported

Clinical Application

Three-phase framework appears implementable in multidisciplinary cancer care settings with appropriate resource allocation Highly relevant to Australian practice; aligns with Cancer Australia survivorship guidelines and could inform Medicare Benefits Schedule items for survivorship care planning Breast cancer survivors post-active treatment across all healthcare settings

Abstract

PURPOSE: The growing population of breast cancer survivors (BCS) underscores the need to address ongoing challenges that persist beyond active treatment. This scoping review aimed to systematically map the unmet needs of BCS and inform the development of an evidence-based survivorship care framework. METHODS: A systematic search of databases identified 13,401 studies, of which 170 met the inclusion criteria. Data were analyzed using qualitative content analysis and descriptive statistics to categorize unmet needs across studies. RESULTS: Six major categories of unmet needs were identified: physical symptom burden, psychosocial/emotional needs, informational needs, healthcare support needs, relational/sexual needs, and financial/occupational needs. Physical symptoms (33.5% of studies) and psychosocial/emotional concerns (32.4%) were most frequently reported. Based on these domains, a three-phase conceptual framework was developed: (1) universal needs screening, (2) targeted, multidisciplinary interventions tailored to individual survivors, and (3) ongoing evaluation through patient-reported outcomes to optimize care. CONCLUSIONS: Unmet needs among BCS are widespread and multifaceted, particularly regarding chronic physical symptoms and persistent psychosocial distress. Existing care frameworks are fragmented and insufficient. The proposed three-phase framework provides a structured approach to delivering proactive, patient-centred survivorship care. IMPLICATIONS FOR CANCER SURVIVORS: Implementing this framework can improve identification and management of unmet needs, enhance quality of life, support long-term physical and emotional recovery, and foster resilience throughout survivorship.

References

  1. 1.Silva, A., Dupuis, K. L., Pourrajabi, A., Kulawic, K., Galica, J., Teggart, K., Abolhasani, R., Lino, M., Schumacher, C., Hayward, S., Taplay, K., Giroux, J., Stark, D., Carroll, B., Luctkar-Flude, M., Winters, E., Conception, J., & Silva, V. S. E. (2026). Beyond breast cancer: mapping unmet needs and advancing an evidence-based framework of survivorship care. Supportive Care in Cancer. https://doi.org/10.1186/s12913-024-11744-z
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