Navigating Latinas with breast screen abnormalities to diagnosis: the Six Cities Study

Area of Science:

• Oncology
• Public Health
• Health Disparities

Background:

• Breast cancer disproportionately affects Latinas, often due to delayed diagnosis.
• Effective strategies are needed to shorten the screening-to-diagnosis timeline in this population.
• Patient navigation's impact on reducing diagnostic delays is not well-documented.

Purpose of the Study:

• To evaluate a culturally sensitive patient navigation program.
• To reduce the time from abnormal screening mammogram to diagnosis in Latinas.
• To increase the proportion of women diagnosed within 30 and 60 days.

Main Methods:

• Analysis of 425 Latinas with BI-RADS 3-5 abnormalities (July 2008-Jan 2011).
• Comparison between a navigated group (n=217) and a control group (n=208).
• Statistical analysis using Kaplan-Meier, Cox regression, and logistic regression.

Main Results:

• Navigated group had a shorter time to diagnosis (32.5 vs 44.6 days; P=.007).
• Significant reduction in diagnosis time for BI-RADS-3 findings (21.3 vs 63.0 days; P<.001), but not BI-RADS-4/5.
• Higher rates of timely diagnosis (≤30 days: 67.3% vs 57.7%; ≤60 days: 86.2% vs 78.4%) in the navigated group, driven by BI-RADS-3.

Conclusions:

• Patient navigation appears to reduce diagnostic time and increase timely diagnoses for Latinas with abnormal mammograms.
• Benefits were primarily observed in women with initial BI-RADS-3 findings.
• Reduced missed appointments likely contributed to improved diagnostic timeliness.