Patient Navigation in Breast Cancer: A Systematic Review

Stephanie Robinson-White, MD; Brenna Conroy, BS; Kathleen H. Slavish, BA; Margaret Rosenzweig, PhD, APN-BC, AOCNP

Disclosures

Cancer Nurs. 2010;33(2):127-140. 

In This Article

Results

PubMed and Ovid Internet search engines resulted in 31 articles meeting the search criteria for patient navigator; 7 for patient navigation and breast cancer; 51,255 for adherence; and 838 journal articles for adherence and breast cancer, by MeSH term match. After applying the inclusion criteria, there were 12 data-based articles evaluating patient navigator efficacy in breast cancer. Articles were analyzed according to specific categories including title, author/year, setting, intervention, design, goal, sample size and racial characteristics of sample, results, conclusions, and limitations (Table 2).

Research studies were conducted during the period from 1999 through April 2009. Nine of 12 interventions (75%) were primarily focused on early-stage intervention, with no navigated role extending into metastatic breast cancer treatment. Most studies (8/12 or 66%) included predominantly or large samples of nonwhite women.

The collection of articles reviewed, although heterogeneous in setting, design, and method, yielded similar outcomes with respect to positive adherence to breast screening and diagnostic follow-up. Goals of navigation interventions were follow-up to screening or clinical breast abnormalities.[32–35,38–40,42,43] Some interventions successfully incorporated quality-of-life components into the navigated intervention.[37,42] The navigation role, whether tested through randomized controlled trial[40–42] or through comparison to historic control,[32,34,35,38,39] was effective for moving women to desired outcome in the breast cancer treatment trajectory. Two of the navigation interventions (16%) were nontraditional. One intervention assisted women with only the emotional aspects of a breast cancer diagnosis,[37] and another used the navigation role to encourage women to follow through with genetic assessment, rather than tumor evaluation or treatment.[41]

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