What Matters in Breast Cancer Survivorship Care? Survivors' and Caregivers' Perspectives on Specialist and Potential Primary Care Involvement in Singapore.

Introduction/ObjectivesIn Singapore, breast cancer survivorship follow-up is largely specialist-led, creating sustainability challenges and leaving psychosocial needs unmet. Although primary care and shared-care models are adopted internationally, they remain underdeveloped locally. This study explored breast cancer survivors' and caregivers' perspectives on the current oncologist-led model and potential primary care involvement in survivorship care.MethodsA qualitative descriptive study was conducted using semi-structured interviews with 37 breast cancer survivors and caregivers recruited purposively from a tertiary cancer centre. Interviews were audio-recorded, transcribed verbatim, and analysed inductively using thematic analysis.ResultsTwo themes and seven subthemes were identified. Experiences with Specialist Outpatient Clinic (SOC) care included trust and continuity with specialists, fragmented care, service coordination, and unmet caregiver support needs. Perspectives on primary care involvement in survivorship care included concerns about primary care provider (PCP) expertise and resources, conditions for greater primary care involvement, and benefits of PCP care. Participants identified continuity, communication, specialist oversight, PCP capability, and care coordination as conditions that increased their comfort with greater primary care involvement in survivorship follow-up.ConclusionsSurvivors and caregivers prioritised continuity, trust, holistic support, and psychosocial care over care settings. While SOC care provided reassurance, participants expressed openness to greater primary care involvement when appropriate safeguards, communication, and continued access to specialist support were maintained. These findings can inform more patient-centred survivorship pathways in Singapore.