Addressing unmet supportive care needs in metastatic breast cancer: A qualitative exploration to inform models of care

Background Advances in diagnostics and treatments have resulted in many individuals with metastatic breast cancer living longer with the disease. A cohort has thus emerged with unique, complex and largely unmet supportive care needs. We performed a qualitative study to explore the views of individuals living with advanced breast cancer and healthcare professionals regarding supportive care services in this cohort. Methods Focus group discussions were conducted with two groups; individuals living with metastatic breast cancer (n = 10) and healthcare professionals (n = 11). Questions addressed: (1) unmet needs, (2) models and supportive care services, (3) barriers and facilitators in service delivery, and (4) future service development. Interviews were recorded, transcribed, and analysed using an inductive thematic content analysis. Results Focus group discussions revealed considerable unmet supportive care needs, varying across the trajectory of the disease. Themes included unmet supportive care needs; lack of services; unmet needs of specific groups such as males and those in the LGBTQI + community; effective types of supportive care and solutions to address unmet needs. Emphasis was placed on the need for accessible and reliable metastatic breast cancer-specific information, directed towards helping individuals live well with the diagnosis. The need for multipronged and coordinated approaches to support individuals across acute, community and palliative care services was highlighted. A shared care and patient-led model of survivorship care was preferred. Dedicated support hubs were suggested as well as improved financial and family support services. Conclusion Focus groups revealed the extent and diversity of the unmet needs of individuals living with metastatic breast cancer. Findings from this research can inform the development of comprehensive supportive care services in the future.