Impact of Patient Navigation on Radiation Therapy Completion in Black Breast Cancer Patients

Objectives: Black breast cancer patients have substantially decreased access to optimal breast-conserving cancer care than white patients. Patient navigation has never been formally implemented into the receipt of radiation therapy (RT) for black patients. We present initial results from an ongoing phase I trial assessing the impact of patient navigation on RT completion in this patient population. Methods: The Navigator-Assisted Hypofractionation (NAVAH) program is a phase I trial (clinicaltrials.gov, NCT05978232) involving black breast cancer patients consented for postlumpectomy RT. Participants were assigned a patient navigator throughout the course of RT and post-RT care, and provided travel vouchers to offset RT transportation cost. Patients refusing trial participation were assessed to determine RT completion rate. The primary trial endpoint is RT completion rate following initiation of patient navigation. Results: Of 54 trial-eligible patients, 36 accepted and 18 declined; no patient had received navigation before being offered trial enrollment. Of those declining enrollment 12/18 (66.7%) completed RT; of these 12, 9 (75%) completed RT without delay. 34/36 patients (94.4%) who enrolled completed RT, of whom 19 (55.9%) completed RT without delay. The differences in RT completion between patients having accepted versus declined trial enrollment were statistically significant ( P = 0.0124). Conclusions: Early results of an ongoing phase I trial reveal that incorporation of patient navigation following initial radiation oncology consultation significantly improves adjuvant RT completion rates in early-stage black breast cancer patients. Further work examining patient navigation is ongoing.