# Supportive Care Needs of Patients with Breast Cancer Who Self-Identify as Black: An Integrative Review

## TL;DR

This paper explores the specific supportive care needs of Black women with breast cancer in Canada, highlighting gaps and priorities for equitable care.

## Contribution

The study identifies and prioritizes high-priority supportive care needs specific to Black-identifying breast cancer patients in the Canadian healthcare context.

## Key findings

- Patient navigation was identified as the top priority need for Black breast cancer patients.
- Financial support and access to culturally tailored information were highlighted as high-priority needs.
- Emotional support and culturally relevant care were also identified as critical for this population.

## Abstract

Black women are more likely to be diagnosed with breast cancer at a younger age and with more aggressive cancers. Once diagnosed, they are less likely to receive appropriate treatments for their cancer and are more likely to experience dose reductions, dose holds, and early treatment termination, which can negatively impact survival. However, little is currently known about the specific supportive care and informational needs of this population, particularly in the Canadian healthcare system context. To address this gap, we performed an integrative review to synthesize the findings of prior needs assessments of patients with breast cancer who were reported to be Black from the published literature and integrated them with the findings of a pan-Canadian needs assessment and prioritization exercise conducted by our team. This work identified patient navigation, financial support, access to culturally tailored information and education, culturally relevant care, racialized data, and emotional support as high-priority needs.

Black-identifying patients face many barriers to the receipt of equitable breast cancer care; however, little is currently known about the unique needs of this patient population, particularly in Canada. To address this gap, we identified and thematically grouped constructs from the published literature reporting on the needs of Black-identifying patients with breast cancer and compared these findings to a list generated through a virtual nominal consensus group (NG) attended by Canadian patients with breast cancer who self-identified as Black (n = 3). A scoping review was undertaken, and relevant citations published from database inception until January 2025 were identified from MEDLINE, Embase, and CINAHL. The literature review yielded 34 articles from the United States and identified 15 constructs consistent with the NG, which spanned the cancer continuum from screening to survivorship. The NG identified four additional constructs that were not found in the literature: advocacy and outreach, communication and health literacy, comorbidities and personalized care, and end-of-life care. The final set of constructs was then validated and prioritized by an expert panel consisting of patients with lived experience and relevant community partner organizations (n = 9) to drive future research, advocacy, and policy work. Patient navigation was identified as the top need, with financial support, access to culturally tailored information and resources, culturally relevant care, racialized data for treatment decision-making, and emotional support identified as high-priority needs.