Abstract
OBJECTIVE: Breast cancer patients often face a significant financial burden, leading to financial toxicity due to the necessity for long-term care, costly treatment, and follow-up measures. The purpose of this study is to systematically review the available qualitative evidence on how breast cancer patients cope with financial toxicity and their unmet need to promote the implementation of effective intervention strategies. METHODS: PubMed, Web of Science, PsycINFO, CINAHL, EMBASE, Scopus, CNKI, Wan Fang Data, and VIP databases were systematically searched for literature related to the study topic. This study was conducted according to the PRIMSA guidelines. Thematic synthesis methods were used to analyze the data and construct themes. The review was pre-registered on PROSPERO (CRD42024502030). RESULTS: The search yielded 1164 results; 23 articles met the inclusion criteria and reported on a total of 1098 breast cancer patients. The thematic analysis identified three themes and 15 sub-themes: coping emotions (shrouded in negative emotions and adopting a positive attitude); coping behaviors (increasing income sources, adjusting personal or family finances, seeking and accepting support, coping independently, avoidance, constrained decision, financial planning, and proactive negotiation); and coping needs (health insurance policy support, medical institutional support, non-medical institutional resources support, financial information needs, financial management needs). CONCLUSION: Breast cancer patients exhibit a variety of emotional reactions and coping behaviors with financial toxicity alongside several unmet needs. This indicates the necessity of maintaining focus on financial toxicity in breast cancer patients and the implementation of appropriate management strategies to address their needs while optimizing the detection and mitigation of expenditures that jeopardize their health and quality of life.