Toxicidade financeira e qualidade de vida relacionada à saúde em mulheres com câncer de mama: a scoping review

Abstract

Introduction: The financial challenges experienced by breast cancer patients significantly impact their lives. Therefore, it is important to understand the impacts of financial toxicity on the health-related quality of life (HRQoL) of women with breast cancer. Objective: To map the impacts of financial toxicity on the HRQoL of women with breast cancer. Method: A scoping review was conducted following the JBI guidelines and the PRISMA-ScR checklist. The search was conducted in major databases such as the Cochrane Library, Excerpta Medica dataBASE (EMBASE), Latin American and Caribbean Literature in Health Sciences (LILACS), Medline/Pubmed, Scopus, Web of Science, and gray literature repositories, with no year or language limits. Two reviewers independently selected the chosen studies using Rayyan software. Studies addressing women diagnosed with breast cancer, of any type and at any stage, financial toxicity, and the impact of this adverse event on HRQoL were included. Data extraction included study characteristics, population, transplant type, and main outcomes. Results: Eleven studies published between 2017 and 2025 were included, mostly crosssectional and conducted in the United States. A direct association was observed between greater financial toxicity and worse HRQoL scores. Direct and indirect costs, such as transportation, medication, and loss of income, aggravated the economic impact and the physical, emotional, and social well-being of women. Factors such as age, marital status, income, employment status, health insurance, and place of origin influenced financial vulnerability, highlighting a higher risk among young, single, unemployed, and low-income women. Conclusion: Financial toxicity is a recurring adverse event that compromises the HRQoL of women with breast cancer, especially among the most socioeconomically vulnerable.