Care trajectories of women with advanced breast cancer at the end of life

Abstract

Objective: To compare the care trajectories of women with advanced breast cancer in the last 30 days of life, analyzing clinical differences and healthcare service utilization between patients undergoing intravenous palliative chemotherapy (IPC) and those followed by specialized palliative care (SPC) teams. Method: A retrospective study based on the analysis of electronicmedical records of 370 women who died between 2019 and 2023, distributed into IPC (n = 176) and SPC (n = 194). Comparisons were performed using the chi-square, Fisher’s exact, or Mann–Whitney tests (p < 0.05). Results: Patients in SPC presented greater metastatic burden (4; IQR 3–5; p < 0.001), greater central nervous system involvement (39.69% vs. 16.48%; p < 0.001), and more multidisciplinary consultations (p < 0.001). They presented lower emergency care utilization (1; IQR 1–2; p < 0.001) and lower hospitalization in the last 24 hours of life (p < 0.001). Conclusion: Follow-up by SPC teams was associated with less aggressive care trajectories at the end of life, even among patients with greater clinical complexity.