Advancing Equity in Breast Cancer Care Through Patient and Public Involvement and Engagement

Disparities in breast cancer care access and outcomes are persistent and globally recognized issues driven by a complex interplay of socioeconomic, geographical, and systemic factors. Given the complex psychosocial effects on this patient group, it is crucial to incorporate Patient and Public Involvement and Engagement (PPIE) into care models. PPIE is a collaborative approach that involves patients, caregivers, and community members. It engages diverse populations and addresses the needs of underrepresented and disadvantaged groups, thereby promoting health equity. However, the multifaceted connection between health equity and PPIE programs must be strengthened. This narrative review critically explores research and organizational models that describe how PPIE informs health equity in breast cancer care. Our focus is on adaptability: as patient needs, treatments, and technologies evolve, so must the strategies employed to ensure equitable care. We discuss how PPIE is crucial for tailoring efforts to provide equity in two areas of intervention: community-driven and data and targeted-driven approaches. Integrating PPIE into flexible organizational models and research projects has emerged as a critical driver for achieving health equity in breast cancer care in both areas. Community-led initiatives ensure that interventions are culturally relevant and address fundamental social determinants of health. Conversely, data-driven approaches provide the evidence needed to target resources effectively and measure progress. Advancing PPIE reporting in rigorous study designs is the first step to ensuring effective and reproducible implementation. Furthermore, the models' adaptive features may reduce health inequities, increasing their reach, and strengthening community collaborations.