Synthesis of clinical practice guidelines and recommendations for breast cancer survivorship care: a systematic review
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Allison Brandt Anbari1, Linda Anderson2, Rebecca Graves3
1Sinclair School of Nursing, University of Missouri, 915 Hitt Street, Columbia, MO, 65212, USA. AnbariA@missouri.edu.
Purpose:
Breast cancer survivorship care is complex and not always provided according to standards or guidelines. Likewise, current cancer survivorship care interventions and programming do not always underscore clinical practice guidelines (CPGs) in the same fashion as interventions for other conditions. A call for improvement in breast cancer survivorship care warrants re-evaluation of current breast cancer survivorship care CPGs. The purpose of this systematic review was to (1) characterize CPGs that include content clinically relevant to people with a history of breast cancer and (2) appraise the possibility of consolidating current CPGs to simplified topics to be presented as a potentially clinically applicable model of breast cancer survivorship care (PROSPERO CRD42024591381).
Methods:
We conducted searches within six databases (PubMed, CINAHL, Scopus, PsycINFO, Cochrane DSR, and Cochrane Central), and in ProQuest Dissertations & Theses Global, ClinicalTrials.gov, and FigShare, Google, Google Scholar, and Bing. We located 3041 records to be screened and 191 records for full-text screening. Based on inclusion criteria considering clinical relevance to people with a history of breast cancer and AGREE II assessments, 21 records were included. We developed a codebook using the NCCN guidelines for cancer survivorship care.
Results:
Areas of concordance were identified as three consolidated topics: risk for recurrence, monitoring for new cancer, and fertility, reproductive, endocrine, and sexual health. These are underpinned by care coordination. Topics include main ideas derived from NCCN guidelines. We labeled each recommendation with main ideas that are more succinct, yet still inclusive/indicative of the full array of CPGs.
Conclusion:
We propose consideration and testing of our consolidated breast cancer survivorship care topics and main ideas. We hypothesize that our model could simplify breast cancer survivorship care provision in primary care settings.
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