Breast cancer mHealth apps across treatment and survivorship: A systematic review of directly evaluated content and features.
Jessica Gonzalez, Sara Donevant, Swann Arp Adams, Tisha M. Felder, Robin Dawson, Beth Sundstrom60
Background: Breast cancer survivors report ongoing information and self-management needs from diagnosis through treatment and survivorship. Commercial mHealth apps could support symptom management, decision-making, communication, and survivorship care planning, but it is unclear whether available apps consistently include these features. The purpose of our study was to characterize what breast cancer patients are likely to encounter in the current mHealth app marketplace by synthesizing evidence from published reviews that manually evaluated apps, rather than relying solely on descriptions in the literature. Methods: We conducted a systematic review following PRISMA reporting guidelines. We searched PubMed, Embase, and CINAHL from database inception through September 4, 2024, for studies that directly evaluated commercially available breast cancer mHealth apps and incorporated a patient perspective. Screening and study selection were managed in Covidence. We included studies assessing ≥2 apps, extracted reported app features, and summarized feature prevalence across included studies using descriptive statistics. Results: Informational content was more common than active support functions. Early detection and diagnosis content was variably present (e.g., self-exam 52%; tumor type 28%, stage 25%). Treatment support was limited (treatment management 23%; side effects 20%; medication management 9%; labs 7%; nutrition 6%). Evidence-aligned resources were inconsistent (referenced research 21%; clinical trials 6%). Connection features were scarce, especially patient–clinician communication (4%), general support (6%), and psychosocial support (18%). Survivorship functions were modest (lifestyle modification 29%; care management 23%; survivorship content 21%); end-of-life content was rare (1%). Conclusions: Breast cancer apps evaluated in published manual reviews frequently underdeliver on functions and content most relevant to patients during active treatment and survivorship, particularly communication, survivorship planning, medication support, psychosocial support, and clinical trial information. Multidisciplinary, evidence-aligned app development and evaluation should address these gaps, include explicit survivorship and treatment-transition workflows, and ensure transparent privacy, safety, and health literacy standards to support informed, values-concordant survivorship care decisions.