Prospective patient navigation program for young women with breast cancer: assessment and referrals to address medical and supportive care needs

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Abstract
Background: Young women with breast cancer (YWBC) face medical and psychosocial challenges that are inconsistently addressed by healthcare frameworks. This study evaluated whether a patient navigation (PN) program for YWBC facilitates access to specialty and supportive care through structured patient needs assessments and referrals. Patients and Methods: Within 3 months of diagnosis, ≤40-year-old patients were prospectively enrolled into a PN program in which a navigator systematically administered needs detection surveys and provided referrals to required services at baseline, 3 months (m), and 6 m. Attendance to referrals at baseline and 3 m was assessed at the next timepoint. Results: Among 189 participants, 85% required >2 referrals at any timepoint. At baseline and 3 m, referrals were mostly to nutrition (66% and 46%), support groups (65% and 24%), and psychology (56% and 36%); and at 6 m, to nutrition (32%), sexology (31%), and psychology (19%). From baseline-to-3m, attendance was highest for support groups (99%), genetic cancer risk assessment (88%), and external breast prosthesis providers (82%); from 3 m-to-6m, for support groups (100%), sexology (91%), and external breast prosthesis (86%). Nearly none attended >2 referrals and receiving more referrals was associated with higher absence rates (p<.001). Conclusion: This PN program enabled structured identification of patients’ needs and referral to required services, highlighting the relevance of nutrition, support groups, and psychology needs during early assessments, as well as sexology counseling during later follow-ups. The high absence rates observed suggest that individualized selection of specific referrals prioritizing patients’ needs and preferences at different timepoints in their cancer trajectory could improve attendance while avoiding patient and health-system oversaturation.

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