# Patient Journey for Triple-Negative Breast Cancer: Optimal Care Pathways vs. Reality of Care in Italian Breast Units

## TL;DR

This study explores the care journey for triple-negative breast cancer patients in Italy, identifying areas of consensus and gaps in care pathways to support the development of optimal treatment guidelines.

## Contribution

The study provides insights into the real-world implementation of care pathways for triple-negative breast cancer, highlighting areas needing improvement and consensus.

## Key findings

- Despite some gaps, there is general consensus on the importance of core aspects of triple-negative breast cancer care.
- Implementation of key care steps is generally adequate, supporting the development of an optimal care journey for patients.
- Involvement of general practitioners and regional publication of Breast Unit lists remain areas needing improvement.

## Abstract

Treatment of triple-negative breast cancer patients poses significant challenges, primarily due to the lack of targeted therapies. The absence of clearly defined care pathways can result in unclear information for patients and differences in variability in care across facilities, a particularly important issue in treating this type of cancer. In this survey, Breast Units’ Coordinators assessed both the perceived importance and the reported implementation of key steps in triple-negative breast cancer management. Despite some gaps—mainly involving the role of general practitioners, waiting times, and the publication of Breast Unit lists by the various Italian regions—the results suggest general consensus and adequate reported implementation of core aspects of triple-negative breast cancer care. These findings support the development of an optimal care journey for triple-negative breast cancer patients grounded in real-world practice, which may aid in the creation of useful guidance where clear pathways are still lacking.

Triple-negative breast cancer (TNBC) represents approximately 15% of all breast cancer diagnoses. Its heterogeneity and absence of targetable receptors make treatment particularly challenging, and it is burdened by a worse prognosis than other breast cancer subtypes. The absence of standardized care pathways may impede the accessibility of information for patients and caregivers. The present survey was conducted as part of a co-participatory process aimed at informing the development of a patient journey for TNBC. A group of statements was developed based on relevant literature, current guidelines, and good practice points (GPPs) for effective TNBC care and subsequently evaluated by a multi-stakeholder panel. Key steps in the care journey were then selected for the survey, and Coordinators of Italian BUs (65.4%) indicated the level of perceived importance and reported implementation of each item. Descriptive statistical analyses were employed. Despite some gaps concerning issues such as the involvement of general practitioners (GPs), data show agreement on perceived importance and generally adequate levels of reported implementation of core aspects of TNBC care, providing support for the development of an optimal care journey for triple-negative breast cancer patients grounded in real-world practice, which may help generate useful guidance where clear pathways are still lacking.