# Global trends in patient-reported outcomes and quality-of-life research for breast cancer: a 20-year bibliometric study

## TL;DR

This study tracks 20 years of breast cancer research on patient-reported outcomes and quality of life, showing growth and shifts in focus toward mental health and patient-centered care.

## Contribution

The study reveals a shift in breast cancer research from survival metrics to psychosocial outcomes and highlights global equity gaps.

## Key findings

- PROs and QoL research in breast cancer grew exponentially, with a surge after 2012.
- The U.S. led in research output, while European nations showed high per-paper influence.
- Recent trends prioritize mental health and immediate breast reconstruction over traditional treatment metrics.

## Abstract

To conduct a 20-year bibliometric analysis of patient-reported outcomes (PROs) and quality-of-life (QoL) research in breast cancer, with focus on evolving priorities in women-centered care, global equity gaps, and implications for survivorship policy.

A bibliometric analysis of publications from 2005 to 2024 was conducted using Web of Science. Following clear inclusion criteria (English articles focusing on PROs/QoL in breast cancer), we analyzed 1857 publications using CiteSpace and VOSviewer to map co-citation networks, keyword bursts, and collaboration patterns.

A bibliometric analysis of 1,857 publications (2005–2024) revealed exponential growth in PROs and QoL research for breast cancer, with a notable surge after 2012. The United States led in output (30%) and influence, while China ranked second in volume but demonstrated lower citation impact. European nations such as France and Spain exhibited high per‑paper influence. Memorial Sloan Kettering Cancer Center was the most productive institution, yet the University of California, San Francisco achieved the highest average citations per paper. Supportive Care in Cancer published the most studies, while the Journal of Clinical Oncology was the most co‑cited. Seminal works—including the BREAST‑Q and EORTC QLQ modules—were the most frequently co‑cited references. Keyword evolution reflected a conceptual shift: early research emphasized “randomized trial” and “adjuvant therapy,” whereas recent trends prioritize “mental health” and “immediate breast reconstruction,” signaling a broader integration of psychosocial and patient‑centered outcomes.

While innovations in PRO tools and survivorship science mark clear progress, the field remains constrained by a Western-centric paradigm that perpetuates inequities in addressing the needs of racial minorities, young patients with fertility concerns, and populations in resource-limited settings. Future efforts require inclusive research governance with strengthened LMIC leadership, contextualized priority-setting to bridge cross-cultural validity gaps, and strategic digital health integration to advance equitable patient-centered care beyond survival metrics.

The online version contains supplementary material available at 10.1007/s10552-025-02097-x.