Treatment completion among people diagnosed with non-metastatic breast cancer in low- and middle-income countries: a scoping review protocol

Breast cancer is the most common cancer globally, with 2.3 million new cases and 666,000 deaths annually. Although mortality has declined substantially in many high-income countries, low- and middle-income countries (LMICs) account for more than 70% of breast cancer-related deaths and have markedly lower 5-year survival rates. The World Health Organization’s Global Breast Cancer Initiative (GBCI) aims to ensure that at least 80% of patients complete multimodality treatment without abandonment; however, treatment completion and abandonment remain inconsistently defined and insufficiently characterized in LMICs. To describe the existing literature on treatment completion among individuals diagnosed with non-metastatic breast cancer in LMICs, including how it is defined and to identify factors associated with treatment abandonment and strategies to improve completion. This scoping review will follow Joanna Briggs Institute methodology and be reported according to PRISMA-Scoping Review checklist. We will search PubMed, Embase, Scopus, and Global index Medicus, for original research published from 2000 onward using a combination of keywords and controlled vocabulary terms for each concept of interest. Eligible studies include individuals with stage I-III or locally advanced non-metastatic breast cancer treated with curative intent and non-report or describe medical reasons for treatment abandonment and/or strategies to improve completion. Covidence will be used for screening and data collection. Two reviewers will independently screen records at title/abstract and full text and extract data using a standardized template. Discrepancies will be resolved by a third reviewer. Data will be summarized descriptively and disseminated through a peer-reviewed journal and presentations.