Telehealth Approach in Breast Cancer Care: A Systematic Review of Models and Outcomes.

Background: Breast cancer remains the most prevalent malignancy among women worldwide and represents a significant global health burden. Advances in treatment have increased survivorship, but many patients continue to experience persistent physical and psychosocial challenges. Telehealth has emerged as a promising approach to delivering continuous, patient-centered care, particularly during the treatment and survivorship phases. Despite its growing application, there is a lack of synthesized evidence regarding the diverse models, content, and clinical benefits of telehealth interventions in breast cancer care. Purpose: This systematic review aimed to identify the effectiveness of telehealth on clinical outcomes in breast cancer patients. Methods: This review followed the PRISMA guidelines and was registered in PROSPERO. A comprehensive literature search was conducted using relevant keywords across PubMed, Scopus, EBSCOhost, Taylor & Francis, and Google Scholar. Eligible studies were RCTs involving telehealth interventions and targeting adult breast cancer patients. Multiple reviewers independently conducted study selection, data extraction, and quality appraisal using the Joanna Briggs Institute critical appraisal tools. Thematic analysis was used to synthesize extracted data. Results: 24 RCTs from 10 countries met the inclusion criteria, with sample sizes ranging from 42 to 454 participants. The studies featured various telehealth models, including psychoeducational, cognitive-behavioral, chronic disease, transtheoritical, behavioural theory, lifestyle management, and nurse-led symptom monitoring model. Delivery methods included telephone calls, web-internet-based platforms, and smartphone applications. Typical intervention contents included education, psychological support, symptom tracking, self-management, empowerment, and exercise guidance. Telehealth interventions have demonstrated positive outcomes, including improvements in quality of life, mood, adherence, self-management skills, self esteem, sleep quality, coping strategy, and also reductions in depression, anxiety,and fatigue. Conclusion: This review highlights the significant role of telehealth as a complementary and integrative component of breast cancer care. It can support patients throughout treatment and survivorship, while improving accessibility and promoting patient-centered outcomes.