Combining Navigation With Breast Cancer Survivorship Care Plans

There may be some benefits for women with breast cancer who receive navigation combined with survivorship care plans (SCPs) following their treatment. However, more research is warranted, according to data presented at the 2019 San Antonio Breast Cancer Symposium.

The use of SCPs, which are personalized documents that summarize a patient’s diagnosis and treatment and outline the late and long-term adverse effects from treatment and include a plan for ongoing surveillance for recurrence, are believed to be beneficial and are endorsed by the Commission on Cancer (CoC). However, there are little data showing how efficacious SCPs may be in breast cancer survivors and there is concern that a significant number of patients may not share their SCPs with their primary care providers.

Researchers conducted a clinical trial in which breast cancer survivors were randomly assigned to receive SCPs with or without patient navigation. In this pilot study, navigators discussed the survivorship care planning and various issues with each patient at the time of SCP delivery. The navigators also followed-up at 6 weeks by phone, and then again at 3 months and 6 months. The primary outcome for this study was breast cancer-related quality of life (QOL) and the secondary outcome was self-efficacy. The researchers also conducted focus groups with the cancer survivors, patient navigators, and oncology providers.

The study included 40 breast cancer survivors who had completed their treatment within 1 to 5 years. In this cohort, 20 spoke English, 10 spoke Spanish and 10 spoke Chinese. There were 20 patients in each arm (10 English speaking, 5 Spanish speaking and 5 Chinese speaking). A total of 32 patients were available for analysis at 6 months and final follow-up.

The researchers found trends towards improvement in the group receiving navigation combined with SCPs in terms of emotional well-being, functional well-being, and overall QOL, but the scores were not statistically significant. There were no significant differences in physical well-being or self-efficacy scores between the two arms.

“We are currently analyzing the qualitative data to assess the implementation of the intervention,” the authors concluded.

Reference

Dixit N, Cicerelli B, Cherian R, et al. Catalyzing navigation for breast cancer survivors (CaNBCS). Poster presentation at: 2019 San Antonio Breast Cancer Symposium; December 10-14, 2019; San Antonio, TX. Abstract P2-13-18.