Patient Navigation Ensures Receipt of Hormonal—but not RT or Chemotherapy—for Breast Cancer

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(ChemotherapyAdvisor) – Patient navigation for women with breast cancer had a positive effect on the receipt of hormonal therapy, but not on radiation therapy or chemotherapy, results from the national Patient Navigation Research Program reported during ASCO's inaugural Quality Care Symposium in San Diego, CA.

Noting that discrepancy in breast cancer outcomes for underserved populations is linked to lack of receipt of quality treatment, “patient navigation programs are being rapidly adopted as a model to improve cancer outcomes for these vulnerable populations, yet the effect of navigation on their quality of cancer care is unknown,” said Naomi Ko, MD, PhD, of the Patient Navigation Research Program at Boston University Medical Center, Boston, MA.

Dr. Ko and colleagues pooled data from seven Patient Navigation Research Program sites and conducted a secondary analysis to determine what proportion of patients newly diagnosed with cancer received care that met National Comprehensive Cancer Network (NCCN) quality metrics for receipt of hormonal therapy for hormone-receptor-positive disease, postlumpectomy radiation therapy, and chemotherapy for hormone negative >1 cm tumors in patients <70 years of age.

Of 1,006 patients with breast cancer eligible for treatment, 491 (49%) were included in the intervention arm and 515 (51%) in the control arm. Mean age was 56 years; 38% were African American and 23% Hispanic; 13% were uninsured and 38% were on Medicaid.

“Among those eligible for hormone therapy, 283/357 (79%) navigated patients received hormonal therapy compared to 237/371 (64%) of controls (P<0.001),” Dr. Ko reported.

However, 85% of navigated patients received radiation vs 83% of controls (P=0.62), and 65% of navigated patients received chemotherapy vs 81% of controls (P<0.007).

“Future studies are needed to assess the role navigation may play in ensuring quality care for the most vulnerable,” Dr. Ko concluded.


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