Navigation and Care Coordination in Breast Cancer

OBJECTIVE: To examine the impact of patient navigation on care coordination, health care access, appointment adherence, psychosocial outcomes, and equity among patients with breast cancer enrolled in the Navigator-Assisted Hypofractionation (NAVAH) trial. METHODS: This prospective comparative analysis used pre- and postradiotherapy (RT) survey data from an ongoing multicenter phase I trial. The pre-RT cohort included 44 patients; post-RT analyses compared 14 patients who electively received navigation with 13 who did not. The cohort was predominantly low-income, with 89% reporting annual household income below $50,000. RESULTS: At baseline, the mean pre-RT composite score was 31.1, with transportation challenges and mixed perceptions of equitable care commonly reported. Post-RT, navigated patients reported more favorable accessibility, accommodation, and acceptability scores than nonnavigated patients, while affordability scores were similar. Complete appointment attendance was 92% with navigation versus 83% without navigation. CONCLUSIONS: Patient navigation was associated with more favorable health care access experiences, though adherence differences were not statistically significant.