Peera Malika, Kennedy Samantha K F, Bhinder Jashmira K, Wu John J, Sharma Kritika, Wong Henry C Y, Zhang Elwyn, Chan Adrian W, Lee Shing Fung, Haywood Darren, Kirk Deborah, Guedes Helena, Thamm Carla, Kwan Jennifer Y Y, Alkhaifi Muna
Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
Sunnybrook Health Sciences Centre, Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
Ann Palliat Med. 2024 Nov;13(6):1502-1512. doi: 10.21037/apm-24-78. Epub 2024 Oct 18.
Breast cancer (BC) is the most prevalent cancer among women worldwide. With a growing number of BC survivors (BCSs), the number of survivors who require high-quality survivorship care is increasing. Various recommendations have been proposed for survivorship care plans (SCPs). However, globally, limited progress has been made to implement these recommendations consistently in cancer care centers. This review explores the gaps and challenges that exist in BC survivorship care (BCSC) and proposes future directions for improving survivorship care for patients and the healthcare system.
Current literature on BCSC was searched using PubMed and Google Scholar. The search strategy utilized a combination of keywords related to BCSC, gaps in survivorship care, and health promotion. Retrievable and English articles from January 2000 to March 2024 were included in the review.
Despite the large number of guidelines and recommendations on best BCSC practices, only a small number of these have been translated into clinical practices that help streamline patient care. There are many gaps to the provision of high-quality survivorship care, all of which negatively affect patient outcomes. Some of these gaps include but are not limited to: the limited role of primary care providers (PCPs), lack of coordination of care, lack of evidence-based research, insufficient data on health promotion, and challenges implementing comprehensive care.
These findings indicate the need for a holistic and personalized approach to BCSC. The importance of implementing a multi-disciplinary and coordinated approach to survivorship care has been emphasized. This includes further involvement of PCPs, through increased training for PCPs in survivorship care. Despite available models of survivorship care, further research is needed to determine optimal BCSC that improves patient outcomes while decreasing the strain on the healthcare system. Additionally, technology can play a beneficial role in survivorship care, especially through telehealth and artificial intelligence (AI). Nonetheless, further research is needed on BCSC.
乳腺癌（BC）是全球女性中最常见的癌症。随着乳腺癌幸存者（BCS）数量的不断增加，需要高质量生存护理的幸存者数量也在上升。针对生存护理计划（SCP）已经提出了各种建议。然而，在全球范围内，癌症护理中心在持续实施这些建议方面进展有限。本综述探讨了乳腺癌生存护理（BCSC）中存在的差距和挑战，并提出了改善患者及医疗系统生存护理的未来方向。
使用PubMed和谷歌学术搜索当前关于BCSC的文献。搜索策略结合了与BCSC、生存护理差距和健康促进相关的关键词。纳入综述的是2000年1月至2024年3月间可检索到的英文文章。
尽管有大量关于最佳BCSC实践的指南和建议，但其中只有少数被转化为有助于简化患者护理的临床实践。在提供高质量生存护理方面存在许多差距，所有这些都对患者结局产生负面影响。其中一些差距包括但不限于：初级保健提供者（PCP）的作用有限、护理缺乏协调、缺乏循证研究、健康促进数据不足以及实施综合护理面临挑战。
这些发现表明需要对BCSC采取全面且个性化的方法。强调了对生存护理实施多学科和协调方法的重要性。这包括通过增加PCP在生存护理方面的培训，让PCP进一步参与进来。尽管有生存护理模式，但仍需要进一步研究以确定能改善患者结局同时减轻医疗系统负担的最佳BCSC。此外，技术可以在生存护理中发挥有益作用，特别是通过远程医疗和人工智能（AI）。尽管如此，仍需要对BCSC进行进一步研究。
