FIGURE 1.
FIGURE 2.
FIGURE 3.
A list of authors with at least 4 published papers in the investigated set of literature
| Authors | Articles | Articles Fractionalized* | No of documents (in % of all) |
|---|---|---|---|
| HAWLEY ST31–33 | 7 | 0.919 | 4.2 |
| OFFODILE AC10,34,35 | 7 | 0.774 | 4.2 |
| WHEELER SB36,38 | 7 | 0.868 | 4.2 |
| BRADLEY CJ29,39,40 | 6 | 1.569 | 3.6 |
| JAGSI R31,32,41 | 6 | 0.701 | 3.6 |
| ASAAD M10,34,35 | 5 | 0.549 | 3 |
| BOUKOVALAS S10,34,35 | 5 | 0.549 | 3 |
| KATZ SJ31–33 | 5 | 0.576 | 3 |
| AZUERO A46 | 4 | 0.522 | 2.4 |
| CHAN A64–67 | 4 | 0.342 | 2.4 |
| COOPER B64–67 | 4 | 0.342 | 2.4 |
| GORDON L45 | 4 | 0.501 | 2.4 |
| HAMILTON AS31,32 | 4 | 0.476 | 2.4 |
| KOCZWARA B64–67 | 4 | 0.342 | 2.4 |
| MIASKOWSKI C64–67 | 4 | 0.342 | 2.4 |
A list of 10 most cited papers in the investigated set of literature (only the first author is listed in case of multiple authors)*
| Paper | DOI/PMID | Total citations | TC per year | Normalized TC |
|---|---|---|---|---|
| Jagsi et al., 2014, J Clin Oncol31 | 10.1200/JCO.2013.53.0956 | 206 | 18.73 | 4.73 |
| Arozullah et al., 2004, J Support Oncol28 | PMID: 15328826 | 161 | 7.67 | 1.00 |
| Bradley et al., 2002, J Health Econ29 | 10.1016/S0167-6296(02)00059-0 | 137 | 5.96 | 1.00 |
| Bradley et al., 2007, Cancer Invest39 | 10.1080/07357900601130664 | 117 | 6.50 | 1.12 |
| Lauzier et al., 2008, J Natl Cancer Inst44 | 10.1093/jnci/djn028 | 111 | 6.53 | 1.51 |
| Jagsi et al., 2018, Cancer32 | 10.1002/cncr.31532 | 104 | 14.86 | 2.82 |
| Meneses et al., 2012, Gynecol Oncol46 | 10.1016/j.ygyno.2011.11.038 | 94 | 7.23 | 2.40 |
| Gordon L et al, 2007, Psycho-Oncology45 | 10.1002/pon.1182 | 92 | 5.11 | 0.88 |
| Greenup et al, 2019, J Oncol Pract37 | 10.1200/JOP.18.00796 | 81 | 13.50 | 4.12 |
| Wheeler et al., 2018, J Clin Oncol36 | 10.1200/JCO.2017.77.6310 | 81 | 11.57 | 2.20 |
A systematization of (financial) toxicity of breast cancer at the level of the individual (left column) and research gap (right column)
| Type of financial burden/burden | Coverage in the literature and research gap |
|---|---|
| 1. Medical costs | Weaker coverage, survey based, depends on social security system, more relevant for private-insurance based system (e.g. US) |
| Treatment expenses | |
| Hospitalization costs | |
| 2. Non-medical costs | Weaker coverage, survey based, depends on social security system, more relevant for private-insurance based system (e.g. US) |
| Travel expenses | |
| Accommodation costs | |
| Other | |
| 3. Out-of-pocket costs | Weak coverage, survey based |
| Deductibles and co-payments | |
| Prescription drug costs* | |
| 4. Loss of income | Well-documented employment impacts, income impacts, less focus on occupational change |
| Changed work hours | |
| Job loss | |
| Change in occupation | |
| Loss/change in income | |
| 5. Insurance-related costs | Weak coverage, depends on social security system, but has broader relevance for other non-medical insurances (life, travel, etc.) |
| 6. Impact on finances and assets: | Weak coverage |
| Debt accumulation | |
| Asset depletion | |
| 7. Psychosocial impact: Stress and anxiety | Well-documented, focus on stress, anxiety, less focus on quality of life as a whole |
| Stress and anxiety | |
| Quality of life | |
| 8. Long-term financial consequences | Increasing interest on recurrence, screening |
| Survivorship costs | |
| Cancer recurrence | |
| 9. Geographical coverage | Vast body of evidence for the US, poorer coverage for EU/European context |
| US | |
| Europe |
Thematic map of (financial) toxicity of breast cancer with most common author keywords for each of the themes and selected references
| Key term(s) | Other key terms* | Selected papers (No. of reference) | |
|---|---|---|---|
| T1: Breast cancer (neoplasms), employment, financial toxicity | Quality of life, return to work, (cancer) survivor(ship), treatment, financial burden / stress, fatigue, chemotherapy, mental health, caregivers, social support, disability, occupation, burnout complaints | 29, 33, 39 | |
| Motor themes | T2: Metastatic breast cancer | Prevalence, healthcare use, healthcare utilization, healthcare costs, advanced breast cancer, adverse effects, administrative claims, breast cancer costs | 48, 49 |
| T3: COVID-19 | Depression, job loss, access to healthcare, breast cancer survivors, cognition, anxiety, autonomy | 50, 51 | |
| Basic themes | T1 Economic burden | Cost(s), oncology, lymphedema, rehabilitation, breast neoplasm, cost-effectiveness, recurrence, screening, cost of illness, cancer, resource utilization, healthcare use | 52–54 |
| Emerging or declining themes | T1: Coping strategies | Breast cancer, healthcare, costs, regional, ethnic differences | 55, 56 |
| Niche themes | T1: Reasonable accommodations | Sick leave, assessment and planning | 57, 58 |