Introduction: Similar to other cancer patients, breast cancer (BC) patients benefit from collaborative care that addresses their supportive care needs (SCN). Although cancer stage influences SCNs, there is limited understanding of the specific needs of those living with metastatic BC (MBC) and how they compare to those with early BC (EBC), restricting assessment of support service adequacy for individuals with MBC.
Aim: To explore similarities and differences in SCNs experienced by Australian women diagnosed with EBC and MBC.
Methods: Qualitative analysis of responses to 3 open-ended questions within an online survey completed by 8,215 individuals connected to Breast Cancer Network Australia (BCNA). Questions assessed: main needs, unmet needs and support wanted. Two samples were identified: all MBC respondents (n=408) and a random sample of EBC (n=499). Written responses for each group were coded and themes derived separately enabling exploration of similarities and differences between groups.
Results: In both samples the majority were aged over 50 (MBC: 78%; EBC: 77%), and around half (MBC: 54%; EBC: 47%) treated in the public system. The same six broad SCN domains (physical, psychosocial, practical, health-care system, information, and existential) were identified in both groups. More MBC (68%) than EBC (58%) reported unmet SCN (68%). Unmet SCNs common to both groups included: living with uncertainty, treatment information; accessing compassionate health care teams, psychological and emotional support, managing side-effects and finances. Unique unmet SCNs for MBC included: accessing timely care, honesty regarding prognosis, end-of-life planning, managing quality of life, home assistance, navigating work, travel for treatment and peer support.
Conclusions: The high level of unmet needs experienced by both EBC and MBC diagnoses, highlights gaps in existing services. To better support individuals and ensure equitable delivery of person-centered care, services must be tailored to address the specific support needs associated with each cancer stage.