Healthcare event types in the cancer care trajectory following initial diagnosis and treatment of female primary and recurrent breast cancer: a scoping review

Abstract Background Women living with and beyond breast cancer often navigate complex care pathways, with limited understanding of longitudinal care trajectories, especially for those with recurrent disease. This scoping review aims to identify and map the types of breast cancer-related healthcare events following initial diagnosis and treatment from the published literature, focusing on conceptualising the post-initial treatment pathway and discrete phases of care. Methods Following Joanna Briggs Institute methodology, a comprehensive search strategy was employed using bibliographic databases and grey literature. Studies published since January 2014 on invasive female breast cancer that describe post-initial treatment healthcare event types were included. Research Screener and Covidence were used for screening and assessment. Data were analysed narratively, focusing on charting healthcare event types as reported in the literature and care phases. Results Analysis of 158 included studies identified 180 unique healthcare event types, grouped into five event categories: diagnostics, follow-ups, treatments, supportive care, and other treatments and services. Subsequent systemic anticancer therapies were the most frequently reported event type, highlighting their utility in monitoring disease progression and long-term care trajectories. Seven literature-derived phases of care were identified: follow-up care after treatment, extended treatments in early breast cancer follow-up, subsequent treatment in early breast cancer, subsequent treatment in metastatic breast cancer, recurrence detection and diagnosis, recurrence treatment, and end-of-life care. End-of-life care was notably underrepresented, with only 11 event types reported across 6 of the 158 studies, reflecting broader gaps in supportive and palliative care in the literature. Conclusions This review maps various types of healthcare events, categorising them into discrete phases of care to conceptualise the post-initial treatment pathway. Due to variation in how included studies described and reported care, some event types common in clinical practice may be underrepresented in the literature. These findings reveal gaps in published research, especially regarding supportive, palliative, and end-of-life care, indicating that current evidence does not adequately reflect the longitudinal care experiences of women with and after breast cancer.