New Horizons for Breast Cancer Care: Patient Navigation in a Low- and Middle-Income Country

PurposeWe established a patient navigation program in a secondary hospital in Malaysia. Here, we report on its impact on diagnostic and treatment timeliness for patients in the first 2 years of its implementation (n = 135 in 2015 and n = 155 in 2016) and compare these patients’ timeliness outcomes with those of patients who were diagnosed in 2014 (n = 147).MethodsA dedicated navigation team provided education, supportive care, and practical help in overcoming individual barriers. Demographic, clinical, and timeliness data were collected and analyzed using Kruskal-Wallis and Fisher’s exact tests.ResultsNavigated patients were more likely to meet national service targets for mammography (95% in 2015 and 96% in 2016 v 74% in 2014; P < .001), biopsy (92% in 2015 and 94% in 2016 v 77% in 2014; P < .001), and communication of news (80% in 2015 and 82% in 2016 v 58% in 2014; P < .001). There was a modest impact on primary surgery (58% in 2015 and 65% in 2016 v 52% in 2014; P = .077) and neoadjuvant chemotherapy ...