The impact of nurse navigation on timeliness to treatment for benign high-risk breast pathology

Breast Cancer Res Treat. 2023 Nov;202(1):129-137. doi: 10.1007/s10549-023-07049-0. Epub 2023 Aug 16.

Abstract

Purpose: High-risk breast pathology is a breast cancer risk factor for which timely treatment is crucial. Nurse navigation programs have been implemented to minimize delays in patient care. This study evaluated nurse navigation in terms of timeliness to surgery for patients with high-risk breast pathology.

Methods: This was a single-institution, retrospective review of patients with identified high-risk breast pathology undergoing lumpectomy between January 2017 and June 2019. Patients were stratified into cohorts based on periods with and without nurse navigation. Preoperative and postoperative time to care as well as demographic and tumor characteristics were compared using univariate and multivariate analysis.

Results: 100 patients had assigned nurse navigators and 29 patients did not. Nurse navigation was associated with reduced time from referral to date of surgery (DOS) by 16.9 days (p = 0.003). Patients > 75 years had a shorter time to first appointment (p = 0.03), and patients with Medicare insurance had a reduced time from referral to DOS (p = 0.005). 20% of all patients were upstaged to cancer on final surgical pathology.

Conclusion: Nurse navigation was significantly associated with decreased time to care for patients with high-risk breast pathology undergoing lumpectomy. We recommend nurse navigation programs as part of a comprehensive approach for patients with high-risk breast pathology.

Keywords: Benign breast pathology; High-risk breast lesion; Nurse navigation; Nurse navigator; Patient navigation.

MeSH terms

  • Aged
  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Medicare
  • Patient Navigation*
  • Referral and Consultation
  • Retrospective Studies
  • United States