Supportive care gaps during breast cancer treatment in Vietnam: Determinants and quality-of-life correlates in a resource-constrained setting.

Abstract

e12733 Background: In low- and middle-income countries (LMICs), breast cancer outcomes are increasingly shaped not only by treatment access but also by unmet supportive care needs. However, evidence clarifying w hich domains are most affected and which patients are at highest risk in resource-constrained settings remains limited. We assessed unmet supportive care needs and their associations with clinical and treatment-related factors and quality of life (QoL) among Vietnamese patients receiving breast cancer treatment. Methods: We conducted a cross-sectional survey of 182 breast cancer patients treated at a university hospital cancer center in Hanoi between November 2024 and May 2025. Unmet supportive care needs were assessed using the patient-reported Vietnamese Supportive Care Needs Survey–Short Form (SCNS-SF34), with domain scores standardized to a 0–100 scale. QoL was measured using the EORTC QLQ-C30 and QLQ-BR23. Internal consistency was high (Cronbach’s α = 0.937; domain α = 0.78-0.93). Group differences in mean domain scores were examined using t-tests for binary factors and one-way ANOVA for variables with three or more categories, with variance checks and appropriate robust methods when assumptions were violated. Associations between unmet needs and QoL outcomes were evaluated using correlation analyses.. Results: The dominant unmet-need domain was health system & information (mean±SD 51.27±19.55), followed by physical/daily living (34.78±20.33) and psychological needs (34.27±26.23); sexuality-related needs were lowest (10.58±20.78). A frequently reported high unmet need was receiving clear updates that the cancer was controlled/remitting (39.6%). Higher unmet needs in the information, physical, and psychological domains were consistently associated with indicators of treatment burden, including greater pain, treatment-related anxiety, more frequent recent hospitalizations, and chemotherapy (all p < 0.05). Unmet needs were closely linked to poorer QoL, with care/support needs correlating with lower role functioning (r = -0.495) and physical functioning (r = -0.429), and higher symptom burden including nausea/vomiting (r = 0.290) and pain (r = 0.260) (all p < 0.001). Conclusions: In this LMIC setting, unmet supportive care needs concentrate on health system communication and information gaps, and extend to physical/daily living and psychological needs that track with treatment burden. These patient-reported needs are strongly associated with functional impairment and symptom burden, underscoring a high-impact, low-resource opportunity to improve quality of care through routine needs screening and targeted nurse-led education, symptom management, and supportive navigation during intensive treatment.