PS5-10-26: Breast Cancer Screening Patient Navigation Decreases Time to Screening and Diagnosis for FQHC Patients

Abstract Background Early breast cancer detection is critical for preventing mortality, yet many patients - especially those that are racial/ethnic minorities, low-income, and underserved - face barriers that prevent them from progressing through the screening and diagnostic pathway in a timely manner. Neighborhood Health (NH) is a Federally Qualified Health Center located in Northern Virginia that serves more than 42,700 patients annually, a majority who identify as racial/ethnic minorities and speak languages other than English. 52% of adult patients are uninsured and 30% are enrolled in Medicaid. Approximately 9,000 patients are women 40-75 years old. In 2024, NH implemented a breast cancer screening and linkage to care program to address low breast cancer screening rates through patient navigation. To assess the impact of our system-level process improvements and pre-diagnostic patient navigation on patient progress through the screening and diagnostic pathway, we compared time between screening and diagnostic exams pre- and post-intervention. Methods To address existing barriers to breast cancer screening for the patient population, two bilingual patient navigators were hired to work one on one with patients, a standing order was implemented to facilitate scheduling by clinical staff and navigators, access to imaging was improved through partnerships with local radiology providers and a mobile mammovan, provider communication was streamlined to ensure timely follow-up, and bi-directional texting was utilized for patient appointment reminders. We analyzed baseline median days between screening referral and completion, screening completion and first diagnostic exam (if recalled), diagnostic referral and completion, and diagnostic exam to biopsy completion to the post-implementation period. We also tracked late-stage cancer diagnoses by year. Results Patient data reflects project period April 2024 to August 2025 and includes completion of 6,602 screening mammograms, 2,072 diagnostic exams, and 325 biopsies. Between 2023 and 2025, the time between screening mammogram referral and completed decreased 48% (79 days to 41 days), time between screening completion and first diagnostic exam (if recalled) decreased 51% (59 days to 29 days), time between diagnostic referral and completion decreased 47% (62 days to 33 days), and time from first diagnostic exam to biopsy completion decreased 48% (40 days to 21 days). Late-stage diagnoses also decreased from 7 (23.3%) patients in the baseline period to 2 (7.4%) patients in 2024. Conclusions System-wide process improvements and implementation of pre-diagnostic patient navigation decreased linkage intervals throughout the breast cancer screening and diagnostic pathway. More work is needed to identify and address remaining barriers to timely completion of outstanding diagnostics and biopsies and to ensure sustainability of patient navigators. Citation Format: M. Welman, J. Henry, N. Hojvat-Gallin. Breast Cancer Screening Patient Navigation Decreases Time to Screening and Diagnosis for FQHC Patients [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-10-26.