Cardoso Fatima, Wuerstlein Rachel, Aruga Tomoyuki, Haidinger Renate, Lambertini Matteo, Benjamin Christine, Valentí Elisenda Llabrés, Criscitiello Carmen, Aapro Matti, Grana Generosa, Gentry Sharon S, Vrdoljak Eduard
Advanced Breast Cancer Global Alliance, Lisbon, Portugal.
Department of Obstetrics and Gynecology, Ludwig Maximilian University, Munich, Germany.
Breast J. 2025 Jun 30;2025:2461234. doi: 10.1155/tbj/2461234. eCollection 2025.
Breast cancer presents a significant risk to public health and is the primary cause of cancer-related death in women. Awareness of metastatic breast cancer (mBC) continues to increase, and advances have been made; however, challenges remain for many patient populations that do not receive equal opportunities along the treatment pathway. The Underserved Patient Population (UPP) Coalition Task Force, a group of international experts in mBC, held meetings between 2022 and 2023 to prioritise the needs of UPPs and propose solutions. The key unmet needs identified included the following: delayed diagnosis of mBC due to difficulties in the presentation of patients to the healthcare system and a lack of primary care physician and non-breast cancer specialist understanding of the signs and symptoms of mBC; difficulty navigating the mBC patient pathway due to suboptimal use of multidisciplinary care and limited communication between HCPs; unequal access to the most appropriate mBC treatment options and supportive therapy due to the unconscious bias of HCPs, and direct and indirect financial toxicity for patients; and negative impact on QoL resulting from the limited uptake of shared decision-making, low prioritisation of patient preferences and a lack of personalised care. This paper aims to shine light on initiatives supporting underserved patients with mBC, illustrate the remaining gaps in care and call upon the global community to change how care is delivered to UPPs.
乳腺癌对公众健康构成重大风险，是女性癌症相关死亡的主要原因。转移性乳腺癌（mBC）的认知度持续提高，也取得了一些进展；然而，许多患者群体在治疗过程中未获得平等机会，仍面临挑战。由mBC国际专家组成的服务不足患者群体（UPP）联盟特别工作组在2022年至2023年期间召开会议，以确定UPP的需求优先级并提出解决方案。确定的关键未满足需求包括：由于患者向医疗系统就诊困难以及初级保健医生和非乳腺癌专科医生对mBC的体征和症状缺乏了解，导致mBC诊断延迟；由于多学科护理利用不足以及医护人员之间沟通有限，在mBC患者就医过程中存在困难；由于医护人员的无意识偏见，患者无法平等获得最合适的mBC治疗方案和支持性治疗，以及患者面临直接和间接的经济毒性；共同决策的采用有限、患者偏好的优先级较低以及缺乏个性化护理对生活质量产生负面影响。本文旨在阐明支持服务不足的mBC患者的举措，说明护理方面仍然存在的差距，并呼吁全球社会改变为UPP提供护理的方式。
