Abstract 1372: The importance of patient navigation in a high risk screening program: the Capital Breast Care Center experience.
Authors: Oppong Bridget A. , Dash Chiranjeev , Coleman Tesha , Lindsay Milajurine T. , Willey Shawna , Adams-Campbell Lucile L. 
Published: August 2014

Background: The Capital Breast Center (CBCC), in the Washington, DC metro area, is a screening facility established to serve minority and underserved women in an effort to address mammography underutilization. Due to widespread outreach and public service information dissemination, women are having mammograms at increasing rates. Current data from the DC Cancer Consortium show that overall, self-reported rates of cancer screening are higher than those among adults nationwide (86.5% reporting having had a mammogram within the last two years vs. 80% nationally). However, compliance or adherence to follow-up after the initial screening mammogram remains an issue. The Center for Disease Control (CDC) recommends a median of less than 60 days between abnormal mammography results and final diagnosis of breast cancer. We present data on follow-up at CBCC.

Methods: All patients screened at CBCC are entered into an electronic medical record (EMR) system starting January 2010. Prospectively collected demographic data was abstracted from the EMR including age, race, insurance status, and the date of the first abnormal screening with the following diagnostic workup. We calculated intervals (in days) between the screening and diagnostic visits. Descriptive statistics and median time to follow-up are reported as the primary outcomes of interest. Differences between Black and Hispanic women on time interval were tested by t-test.

Results: From January 2010 to December 2011, 2,430 digital screening mammograms were preformed. Of those who reported race(86%), 46% identified as Black, 37% as Hispanic, and 3% as “Other”. 353 (15%) of the tests yielded an abnormal result. 320 (91%) women returned for the recommended follow-up appointment for diagnostic imaging. The median interval between screening and diagnostic imaging was 40 days (Interquartile range: 28-58 days). Of the 34 women who were recommended to have a core needle biopsy after the diagnostic imaging, 28 (82%) underwent biopsy within a median of 19.00 days (interquartile range: 11-37 days). Overall, there were 5 high risk lesions (atypia) and 19 cancers (1.9 cancers per 1,000) diagnosed in the two year period. There was no statistically significant difference in the interval between screening and diagnostic evaluation or diagnostic mammogram and biopsy between Black and Hispanic women.

Conclusion: CBCC, with culturally sensitive patient navigators has managed to get patients to return for follow-up breast care in a timely manner (within the CDC recommended performance standard). For a population that is majority low income Black and Hispanic women with a high risk of noncompliance, we have minimized delays to breast cancer diagnosis by providing navigation services to all patients.

Citation Format: Bridget A. Oppong, Chiranjeev Dash, Tesha Coleman, Milajurine T. Lindsay, Shawna Willey, Lucile L. Adams-Campbell. The importance of patient navigation in a high risk screening program: the Capital Breast Care Center experience. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1372. doi:10.1158/1538-7445.AM2013-1372