From Prevention to Palliative Care: Optimizing the Breast Cancer Patient Experience With Nurse Navigation

Breast cancer is the most commonly diagnosed cancer in women, with incidence rates of invasive cancer upwards of 200,000 new cases per year plus an estimated additional 63,000 cases of in situ breast cancer.¹ Because of this, more than 3.5 million breast cancer survivors are alive today either with a history of breast cancer or are currently undergoing treatment for metastatic disease.

The role of the breast cancer nurse navigator is an essential component of providing quality care to patients throughout the continuum of breast care. In most clinical practices, the role of the nurse navigator was implemented in breast imaging centers to help facilitate a timely diagnosis for patients who were recommended to undergo breast biopsy. Then, the role was expanded to include assisting patients with newly diagnosed disease through the complexities of a breast cancer care from diagnosis to survivorship.

Regardless of their practice setting, the breast care nurse navigator should be knowledgeable in all aspects of the breast cancer care continuum. The most common responsibilities for the nurse navigator working to improve early detection are to provide evidence-based education on the screening guidelines, risk assessment, and reduction interventions, and collaborate with the multidisciplinary team to ensure care is coordinated in a timely manner.²

Once a patient receives a diagnosis of breast cancer, providing psychosocial support, assessing barriers to care along with ongoing education is vital to helping the patient have a better understanding of her diagnosis and proposed treatment plan. The unique relationship between the nurse navigator and the patient has been shown to reduce gaps in care, thus improving adherence to the recommended treatment plan and greater patient satisfaction.³

As the number of people with breast cancer continues to increase, challenges exist for the nurse navigator to balance volume along with acuity. In many settings, acuity tools have been developed to assist the navigator with this process. Acuity tools take into account the stage of the cancer, treatment(s) recommended, and comorbidities, as well as social determinants of health that may affect treatment adherence, such as literacy, insurance, and transportation. The higher the acuity, the more time the nurse navigator will need to spend with the patient.⁴