Abstract Background: Breast cancer is the leading cancer among Indian women, yet the national 5-year survival rate remains below 65%, largely due to delayed presentation and high rates of treatment non-completion. Historical Indian studies report treatment adherence rates between 55-70%, with dropout rates as high as 30-40%, especially in rural and low-income settings. To address these challenges, we piloted a survivor-led patient navigation model grounded in community participation, digital supervision, and sustainability. Methods: A five-phase pilot program was implemented at two tertiary hospitals in West Bengal, India. Fourteen breast cancer survivors were recruited and trained through a structured 4-week online course. After simulation-based assessment, they began navigating real patients, supported via moderated WhatsApp groups that included the patient, navigator, and treating clinician. Navigators from one hospital were assigned to patients from the other to maintain neutrality. Results: Over a 6-month period, navigators supported 82 newly diagnosed breast cancer patients. Compared to historical Indian data indicating adherence rates of ∼65%, the pilot demonstrated a treatment completion rate of 89.0%, with a dropout rate of 11.0%—representing a ∼60% relative reduction in dropout. Navigators helped patients overcome key psychosocial and logistical barriers, including fear of surgery, misinformation about chemotherapy, financial uncertainties, and loss to follow-up. Patient-reported feedback indicated increased trust, better communication, and improved emotional resilience throughout treatment. Conclusion: This low-cost, survivor-led patient navigator model significantly outperformed historical national benchmarks in terms of treatment adherence and retention. The model is scalable, culturally adaptive, and resource-appropriate for LMICs. It aligns with the WHO Global Breast Cancer Initiative goals and presents a strong case for integration into India’s National Programme for Prevention and Control of Non-Communicable Diseases (NPCDCS). Citation Format: S. Das, T. Mandal, A. Mallick, R. Agarwal, P. Basu, R. Jena. A Survivor-Led Patient Navigation Model to Improve Breast Cancer Treatment Adherence in India: Results from a Pilot Project abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-10-28.
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