Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations

BACKGROUND: Breast cancer is the most common cancer among women, with improved survival rates due to advances in early diagnosis and therapies. However, long-term survivors (≥5 years post-treatment, disease-free) face persistent physical, psychological, and social challenges requiring tailored, evid...

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Autores: Pimentel Parra, Gustavo Adolfo, García Vivar, Cristina, Escalada Hernández, Paula, Santos Martín, José Luis, Soto Ruiz, María Nelia
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad Pública de Navarra
Repositorio:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:academica-e.unavarra.es:2454/54333
Acceso en línea:https://hdl.handle.net/2454/54333
Access Level:acceso abierto
Palabra clave:Breast cancer survivorship
Clinical Practice Guidelines (CPGs)
Long-term outcomes
Psychosocial care
Evidence-based recommendations
Survivorship care framework
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spelling Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendationsPimentel Parra, Gustavo AdolfoGarcía Vivar, CristinaEscalada Hernández, PaulaSantos Martín, José LuisSoto Ruiz, María NeliaBreast cancer survivorshipClinical Practice Guidelines (CPGs)Long-term outcomesPsychosocial careEvidence-based recommendationsSurvivorship care frameworkBACKGROUND: Breast cancer is the most common cancer among women, with improved survival rates due to advances in early diagnosis and therapies. However, long-term survivors (≥5 years post-treatment, disease-free) face persistent physical, psychological, and social challenges requiring tailored, evidence-based care. Despite the growing survivor population, no systematic evaluation of Clinical Practice Guidelines (CPGs) for this group has been conducted. This study assesses the quality of CPGs and their evidence-based recommendations. METHODS: A systematic review was conducted in PubMed, CINAHL, and Cochrane Library (2015–2023), including guidelines from major oncology organisations. The AGREE II instrument evaluated CPG quality across six domains, and recommendations were classified using a Primary Care survivorship framework: prevention, surveillance, care coordination, and long-term effect management. RESULTS: Ten CPGs met inclusion criteria, with 7 classified as high quality. Most recommendations focused on prevention (adjuvant therapy, alcohol) and surveillance (follow-up, mammography), while gaps remained in lifestyle guidance, psychosocial support, and management of complications (lymphedema, osteoporosis, cognitive dysfunction). Care coordination and psychosocial interventions were inconsistently addressed. CONCLUSIONS: Current CPGs inadequately cover the complex needs of long-term survivors, particularly in psychosocial care. Evidence-based, patient-centred guidelines are urgently needed to optimise long-term outcomes and quality of life.This research was funded by the National Institute of Health Carlos III (ISCIII), Spain, grant number PI21/00894.Springer NatureCiencias de la SaludOsasun ZientziakInstitute of Smart Cities - ISC2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/mswordhttps://hdl.handle.net/2454/54333reponame:Academica-e. Repositorio Institucional de la Universidad Pública de Navarrainstname:Universidad Pública de NavarraInglésinfo:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 (ISCIII)/PI21%2F00894© The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:academica-e.unavarra.es:2454/543332026-06-17T12:41:47Z
dc.title.none.fl_str_mv Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations
title Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations
spellingShingle Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations
Pimentel Parra, Gustavo Adolfo
Breast cancer survivorship
Clinical Practice Guidelines (CPGs)
Long-term outcomes
Psychosocial care
Evidence-based recommendations
Survivorship care framework
title_short Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations
title_full Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations
title_fullStr Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations
title_full_unstemmed Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations
title_sort Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations
dc.creator.none.fl_str_mv Pimentel Parra, Gustavo Adolfo
García Vivar, Cristina
Escalada Hernández, Paula
Santos Martín, José Luis
Soto Ruiz, María Nelia
author Pimentel Parra, Gustavo Adolfo
author_facet Pimentel Parra, Gustavo Adolfo
García Vivar, Cristina
Escalada Hernández, Paula
Santos Martín, José Luis
Soto Ruiz, María Nelia
author_role author
author2 García Vivar, Cristina
Escalada Hernández, Paula
Santos Martín, José Luis
Soto Ruiz, María Nelia
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Ciencias de la Salud
Osasun Zientziak
Institute of Smart Cities - ISC
dc.subject.none.fl_str_mv Breast cancer survivorship
Clinical Practice Guidelines (CPGs)
Long-term outcomes
Psychosocial care
Evidence-based recommendations
Survivorship care framework
topic Breast cancer survivorship
Clinical Practice Guidelines (CPGs)
Long-term outcomes
Psychosocial care
Evidence-based recommendations
Survivorship care framework
description BACKGROUND: Breast cancer is the most common cancer among women, with improved survival rates due to advances in early diagnosis and therapies. However, long-term survivors (≥5 years post-treatment, disease-free) face persistent physical, psychological, and social challenges requiring tailored, evidence-based care. Despite the growing survivor population, no systematic evaluation of Clinical Practice Guidelines (CPGs) for this group has been conducted. This study assesses the quality of CPGs and their evidence-based recommendations. METHODS: A systematic review was conducted in PubMed, CINAHL, and Cochrane Library (2015–2023), including guidelines from major oncology organisations. The AGREE II instrument evaluated CPG quality across six domains, and recommendations were classified using a Primary Care survivorship framework: prevention, surveillance, care coordination, and long-term effect management. RESULTS: Ten CPGs met inclusion criteria, with 7 classified as high quality. Most recommendations focused on prevention (adjuvant therapy, alcohol) and surveillance (follow-up, mammography), while gaps remained in lifestyle guidance, psychosocial support, and management of complications (lymphedema, osteoporosis, cognitive dysfunction). Care coordination and psychosocial interventions were inconsistently addressed. CONCLUSIONS: Current CPGs inadequately cover the complex needs of long-term survivors, particularly in psychosocial care. Evidence-based, patient-centred guidelines are urgently needed to optimise long-term outcomes and quality of life.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.none.fl_str_mv https://hdl.handle.net/2454/54333
url https://hdl.handle.net/2454/54333
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv info:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 (ISCIII)/PI21%2F00894
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
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dc.publisher.none.fl_str_mv Springer Nature
publisher.none.fl_str_mv Springer Nature
dc.source.none.fl_str_mv reponame:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
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instname_str Universidad Pública de Navarra
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