Families living with metastatic breast cancer face complex and evolving psychosocial challenges, but family support interventions remain limited: a scoping review

PURPOSE: Psychosocial challenges of living with metastatic breast cancer are well documented for patients, but less is known about their impact on families. Understanding family perspectives and existing support interventions is essential to strengthen care for families. This scoping review aimed to map psychosocial experiences of patients with metastatic breast cancer and their families and to identify existing family support interventions. METHOD: Following Joanna Briggs Institute guidance and PRISMA-ScR standards, a comprehensive search was conducted in MEDLINE, CINAHL, Embase, PsycINFO, and Scopus, supplemented by grey literature. The final search was performed in November 2025. Two reviewers independently screened titles/abstracts and full texts. Data were synthesised narratively using reflexive thematic analysis. RESULTS: A total of 56 studies were included. 46 studies described psychosocial experiences, highlighting substantial emotional, relational, and practical challenges affecting patients and families across the MBC trajectory. Four themes emerged: Managing psychosocial and emotional challenges; Navigating family relationships and communication; Adapting to role changes and practical burdens in the family; and Seeking support and coping with end-of-life challenges. Ten studies reported support interventions, which were few, heterogeneous, and mainly showed short-term or feasibility outcomes. No studies were identified that examined families' experiences of routine disease monitoring. CONCLUSIONS: Families experience complex and evolving psychosocial challenges, while existing family support interventions remain limited and do not reflect the changing needs of families. The absence of research on routine disease monitoring represents a critical gap. Future research should inform the development of flexible, family-oriented support interventions aligned with changing needs over time.