Breast cancer patient navigation to identify individual needs and offer medical and supportive care referrals.

Abstract

1547 Background: Despite evidence that patient navigation (PN) improves access to comprehensive care for patients with breast cancer (BC), its adoption in Mexico remains limited, likely due to multifactorial barriers. To address this gap, our center implemented one of the country’s first PN programs to systematically identify and document patients’ medical and support needs and provide referrals to appropriate services. This study describes patient needs and referral attendance up to 6 months (m) post-diagnosis. Methods: Patients newly diagnosed with BC are identified after their first medical oncology consultation at Hospital Zambrano Hellion TecSalud and are consecutively invited to the PN program, which consists of assessments at baseline, 3m, and 6m. At each timepoint, patients answer validated surveys and target questions to explore their needs. The navigator then shares the results with each patient and refers them to the required specialty or support services. Attendance to baseline and 3m referrals is assessed at 3m and 6m, respectively. This analysis includes patients navigated from 2020-2025. Results: 421 patients had reached 6m of follow-up: 357 (85%) and 261 (62%) completed their 3m and 6m navigation, respectively. Median age at diagnosis was 48 years (IQR 41-58). Most were married (76%), and had ≥1 child (84%), higher education (75%), and private healthcare (76%). The most common baseline referrals were to nutrition (86%), psychology (68%), support groups (47%), and wig providers (42%). At follow-up, patients mainly required referral to sexology counseling (3m: 82%, 6m: 79%), nutrition (3m: 78%, 6m: 77%), psychology (3m: 51%, 6m: 39%), and lymphedema counseling/therapy (3m: 40%, 6m: 66%). Attendance was highest to support groups (90-95%), wig providers (64-87%), and geriatric assessment (67-80%). Despite high need, attendance was notably lower for nutrition (47-52%), psychology (58%), and sexology counseling (0%). Main reasons for nonattendance were lack of interest (48%), time constraints (38%), and financial issues (10%). Conclusions: In this PN program, referrals were mostly needed for nutrition, sexology, and psychology. While attendance was high for some services, rates were suboptimal for the most common referrals, especially sexology counseling. Efforts to better convey referral rationale and importance may increase uptake and access to comprehensive quality-of-life focused care. Patient needs and attendance to referrals. BaselinereferralsN=421 (%) Baseline - 3mattendance% 3mreferralsN=357 (%) 3m - 6mattendance% 6mN=261 (%) Nutrition 361 (86) 47 278 (78) 52 202 (77) Sexology - - 291 (82) 0 206 (79) Psychology 287 (68) 58 181 (51) 58 102 (39) Support group 197 (47) 90 90 (25) 95 47 (18) Wigs 175 (42) 87 22 (6) 64 8 (3) Lymphedema 134 (32) 28 144 (40) 23 171 (66) Geneticist 126 (30) 69 42 (12) 43 25 (10) Fertility preservation 78 (19) 52 19 (5) 100 3 (1) Geriatrics 7 (2) 67 5 (1) 80 5 (2)