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Observational Study
. 2025 May 5;33(6):449.
doi: 10.1007/s00520-025-09502-w.

Impact of the implementation of an embedded palliative care model in the continuum of care for patients with metastatic breast cancer

Leonor Vasconcelos de Matos  1 , Tatiana Louro  2 , Teresa Gantes Padrao  2 , Marcio Debiasi  2 , Berta Sousa  2 , Helena Gouveia  2 , Fatima Cardoso  2
Affiliations
Observational Study

Impact of the implementation of an embedded palliative care model in the continuum of care for patients with metastatic breast cancer

Leonor Vasconcelos de Matos et al. Support Care Cancer. .

Abstract

Purpose: Timely and integrated palliative care is crucial for patients with metastatic breast cancer. However, data on models of integration are scarce. We aimed to evaluate the impact of the integration of an embedded model of palliative care in a multidisciplinary breast unit on important goals of care and to characterize different patterns of integration (palliative predominant, oncology predominant or concurrent).

Methods: Single-center, retrospective, observational cohort study including all patients with metastatic breast cancer followed by the palliative and oncology teams from a 12-month period before (pre-implementation) and after (post-implementation) of an embedded model of integration of palliative care. We analyzed early integration, 1-year survival rate, survival and different patterns of coordination of palliative care and oncology (the oncology-predominant pattern, the palliative care-predominant pattern and the concurrent integrated care pattern).

Results: From April 2020 to April 2022, a total of 145 patients were included in the analysis: all female, median age of 63.5 years, 20.7% with triple negative disease. Post-implementation, early referrals significantly increased (35.3 to 61.3%, p < 0.01), 1-year survival rate (40.1% vs 40.7%) and survival time were similar (9.2 months vs 9.9 months). An integrated pattern of care with concurrent palliative and oncology appointments was significantly more frequent (30% vs 61%, p < 0.01). When compared to the other patterns, the concurrent pattern was associated to a median of 4 months longer survival (p < 0.01).

Conclusions: The incorporation of an embedded model of palliative care was associated with earlier referrals and translated into better outcomes for patients with metastatic breast cancer.

Keywords: Breast cancer; Metastatic; Palliative care.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patient enrollment
Fig. 2
Fig. 2
Patterns of PC and oncology integration, before and after the implementation of the embedded pc clinc
Fig. 3
Fig. 3
Kaplan–Meier curves for survival time in the analysis population, which included 145 patients, by study group
Fig. 4
Fig. 4
Kaplan–Meier curves for survival time in the analysis population, which included 145 patients, by model of integration of PC and Oncology. ONC oncology-led pattern, PALL palliative-led pattern, CONC concurrent integrated model of palliative care and oncology
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