Table 1 Inclusion and exclusion criteria

Population:

Studies which report women aged > 18 and with a confirmed SBC diagnosis who accessed/received treatment with SACT. This will include studies which report all clinical sub types across all sites of metastases and will include de novo presentations

Studies which report primary and/or locally advanced (LABC) early stage (I-III) breast cancer only

Studies which report (comparative) treatment effect and efficacy

Males with a secondary breast cancer diagnosis as this is classified as a rare disease

Phenomena of interest:

Studies which explore individual, clinical and contextual factors associated with access to SACT for SBC

Studies which do not explore individual, clinical and contextual factors associated with the primary outcome

Intervention/Exposure:

Studies reporting individual factors, which include, age, gender, sexual orientation, race/ethnicity, socioeconomic status, education, language and literacy, psychosocial characteristics

Clinical characteristics which include, sub type, HR status, HER2 status, previous treatment response, physician characteristics

Contextual factors which include geography and geographical location, distance, travel time, health region, catchment/referral areas and organisational factors including, health care system factors, capacity, service availability

Studies which do not report individual, clinical and contextual factors associated with the primary outcome

Outcome(s):

Studies which report access in terms of receipt non receipt of one or more a systemic anti-cancer therapy(ies)

For the purposes of the review access will be defined as receipt/non receipt of a systemic anti-cancer therapy which will include chemotherapy, immunotherapy, targeted therapy and hormone/endocrine therapy

Studies which do not report the primary outcome measure of receipt/non receipt of one or more a systemic anti-cancer therapy(ies)

Types of study:

Quantitative, qualitative and mixed methods studies. This will include observational, cross sectional, longitudinal and analytic studies, including, epidemiological studies, case control and cohort studies

Qualitative studies will include designs such as phenomenology, grounded theory, ethnography, action research and feminist research

Mixed method studies will only be considered if data from the quantitative or qualitative components can be clearly extracted

Peer reviewed, original research studies published in English language from January 2000 onwards reporting quantitative, qualitative or mixed methods

Studies which report (comparative) treatment effect, efficacy and studies reporting clinical trials of systemic anti-cancer therapies, as whilst RCT is not a specific exclusion criteria it is likely that RCTs will measure treatment effect as opposed to access as an outcome and would therefore be excluded