Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2012

01-10-2012 | Breast Oncology

Patient Navigation and the Quality of Breast Cancer Care: An Analysis of the Breast Cancer Care Quality Indicators

Authors: Joseph J. Weber, MD, Debra C. Mascarenhas, RN, Lisa S. Bellin, MD, Rachel E. Raab, MD, Jan H. Wong, MD

Published in: Annals of Surgical Oncology | Issue 10/2012

Login to get access

Abstract

Purpose

Patient navigation programs are initiated to help guide patients through barriers in a complex cancer care system. We sought to analyze the impact of our patient navigator program on the adherence to specific Breast Cancer Care Quality Indicators (BCCQI).

Methods

A retrospective cohort of patients with stage I–III breast cancer seen the calendar year prior to the initiation of the patient navigation program were compared with patients treated in the ensuing two calendar years. Quality indicators deemed appropriate for analysis were those associated with overcoming barriers to treatment and those associated with providing health education and improving patient decision-making.

Results

A total of 134 consecutive patients between January 1, 2006 and December 31, 2006 and 234 consecutive patients between January 1, 2008 and December 31, 2009 were evaluated for compliance with the BCCQI. There was no significant difference in the mean age or race/ethnic distribution of the study population. In all ten BCCQI evaluated, there was improvement in the percentage of patients in compliance from pre and post implementation of a patient navigator program (range 2.5–27.0 %). Overall, compliance with BCCQI improved from 74.1 to 95.5 % (p < 0.0001). Indicators associated with informed decision-making and patient preference achieved statistical significance, while only completion axillary node dissection in sentinel node-positive biopsies in the process of treatment achieved statistical significance.

Conclusions

The implementation of a patient navigator program improved breast cancer care as measured by BCCQI. The impact on disease-free and overall survival remains to be determined.
Appendix
Available only for authorised users
Literature
1.
Ensuring quality cancer care. National cancer policy board, Institute of Medicine and National Research Council. Washington, DC: National Academies; 1999.
2.
The Commonwealth Fund Commission on high performance health system, Why not the best? Results from the National Scorecard on U.S. health system performance. The Common Wealth Fund October 2011.
3.
Shavers VL, Brown ML. Racial and ethnic disparities in the receipt of cancer treatment. J Natl Cancer Inst. 2002;94:334–57.PubMedCrossRef
4.
Elmore JG, Nakano CY, Linden HM, Reisch LM, Ayanian JZ, Larson EB. Racial inequities in the timing of breast cancer detection, diagnosis, and initiation of treatment. Med Care. 2005;43:141–8.PubMedCrossRef
5.
Natale-Pereira A, Enard KR, Nevarez L, Jones LA. The role of patient navigators in eliminating health disparities. Cancer. 2011;117:3543–52.PubMedCrossRef
6.
Wells KJ, Battaglia TA, Dudley DJ, et al. Patient navigation: state of the art or is it science? Cancer 2008;113:1999–2010.PubMedCrossRef
7.
Hewitt ME, Simone J. National Cancer Policy Board, Institute of Medicine: Ensuring Quality Cancer Care. Washington, DC; 1999.
8.
Edwards BK, Brown ML, Wingo PA, et al. Annual report to the nation on the status of cancer, 1975–2002, featuring population-based trends in cancer treatment. J Natl Cancer Inst. 2005;97:1407–27.PubMedCrossRef
9.
Malin JL, Schneider EC, Epstein AM, Adams J, Emanuel EJ, Kahn KL. Results of the national initiative for cancer care quality: how can we improve the quality of cancer care in the United States? J Clin Oncol. 2006;24:626–34.PubMedCrossRef
10.
Donelan K, Mailhot JR, Dutwin D, et al. Patient perspectives of clinical care and patient navigation in follow-up of abnormal mammography. J Gen Intern Med. 2011;26:116–22.PubMedCrossRef
11.
12.
Lohrisch C, Paltiel C, Gelmon K, et al. Impact on survival of time from definitive surgery to initiation of adjuvant chemotherapy for early-stage breast cancer. J Clin Oncol. 2006;24:4888–94.PubMedCrossRef
13.
Palmieri FM, DePeri ER, Mincey BA, et al. Comprehensive diagnostic program for medically underserved women with abnormal breast screening evaluations in an urban population. Mayo Clin Proc. 2009;84:317–22.PubMed
14.
Guadagnoli E, Shapiro CL, Weeks JC, Gurwitz JH, Borbas C, Soumerai SB. The quality of care for treatment of early stage breast carcinoma: is it consistent with national guidelines? Cancer. 1998;83:302–9.PubMedCrossRef
15.
Battaglia TA, Roloff K, Posner MA, Freund KM. Improving follow-up to abnormal breast cancer screening in an urban population. A patient navigation intervention. Cancer. 2007;109:359–67.PubMedCrossRef
16.
Cheng SH, Wang CJ, Lin JL, et al. Adherence to quality indicators and survival in patients with breast cancer. Med Care. 2009;47:217–25.PubMedCrossRef
17.
Parker VA, Clark JA, Leyson J, et al. Patient navigation: development of a protocol for describing what navigators do. Health Serv Res. 2010;45:514–31.PubMedCrossRef
18.
Ferrante JM, Chen PH, Kim S. The effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: a randomized controlled trial. J Urban Health. 2008;85:114–24.PubMedCrossRef
19.
Metadata
Title
Patient Navigation and the Quality of Breast Cancer Care: An Analysis of the Breast Cancer Care Quality Indicators
Authors
Joseph J. Weber, MD
Debra C. Mascarenhas, RN
Lisa S. Bellin, MD
Rachel E. Raab, MD
Jan H. Wong, MD
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2527-8

Other articles of this Issue 10/2012

Annals of Surgical Oncology 10/2012 Go to the issue

Breast Oncology

National Practice Patterns in Preoperative and Postoperative Antibiotic Prophylaxis in Breast Procedures Requiring Drains: Survey of the American Society of Breast Surgeons

Breast Oncology

Breast Surgery Outcomes as Quality Measures According to the NSQIP Database

Breast Oncology

Intraoperative Imprint Cytology and Frozen Section Pathology for Margin Assessment in Breast Conservation Surgery: A Systematic Review

Breast Oncology

The Value of Mammography Within 1 Year of Conservative Surgery for Breast Cancer

Breast Oncology

Disease Recurrence in Sentinel Node-Positive Breast Cancer Patients Forgoing Axillary Lymph Node Dissection

Breast Oncology

Tumor Bed Control with Balloon-Based Accelerated Partial Breast Irradiation: Incidence of True Recurrences Versus Elsewhere Failures in the American Society of Breast Surgery MammoSite® Registry Trial