Perceptions of voluntary workers in cancer organisations on the knowledge of secondary breast cancer symptoms , healthcare communication and diagnostic referral pathways among the patients they support in Northern Ireland

Background: In secondary breast cancer (SBC) cancer cells spread to other areas of the body and at this stage treatment is no longer curative. Studies show increase in SBC prevalence in the United Kingdom (UK) and also linked early detection to lower mortality rates and better prognosis. Studies have reflected that adequate healthcare communication can enhance early diagnosis and improve patients' quality of life. Aim: Explore perceptions of voluntary workers in cancer organisations on knowledge of SBC symptoms, healthcare communication and diagnosis impact among patients they support in Northern Ireland (NI). Method: Descriptive exploratory approach using semi-structured interviews with a purposive sample of five voluntary workers from breast cancer organisations between June-August 2023. Data was analysed using thematic analysis to develop descriptive themes. Results: Themes developed include: Lack of awareness and knowledge of SBC; Communication gap in breast cancer care provision; Impact of diagnosis; Gaps in SBC cancer care. Findings suggest limited support for SBC patients, healthcare communication is not optimal, and impacts patients' experiences and delayed diagnosis. Awareness of patients, public, HCPs is unclear and there are limited SBC nurses, support groups, information on SBC, limited access to clinical trials, and treatment options for SBC patients. Conclusions: SBC awareness is limited in NI, therefore efforts to provide more information and better support for SBC patients through provision of more SBC nurses, support groups and accessibility to clinical trial can facilitate better experiences through their illness journey. HCPs training on person-centred communication can influence better outcomes for SBC patients.