Abstract PO4-10-11: Needs of oncology nurse navigators serving young or metastatic breast cancer patients
Authors: Owens Kelly , Dean Marleah , Clark Elizabeth Bourquardez , Welcsh Piri , Rose Diane , Kuhn Erica , Conaty Jessica , Pugh-Yi Robin , Friedman Susan 
Published: May 2024

Abstract
Oncology nurse navigators (ONN) facilitate breast cancer patients' care via information, resources, and referral services. Two important groups of breast cancer patients served by ONN are young women with breast cancer (yBC), defined as women diagnosed at age 45 or younger, and metastatic breast cancer (mBC) patients. These two groups of patients have distinct needs for clinical care and services. To better understand the needs and experiences of ONN serving these patients, we surveyed 52 active ONN in the United States via an online needs assessment survey about their familiarity with topics relevant for breast cancer patients, referral patterns, and perception of educational needs.
As expected, most ONNs saw more yBC than mBC patients. Familiarity of ONN with topics relevant for yBC and mBC differed based on their work experience. For some topics, earlier-career ONN (&lt;5 years of work experience) reported distinct experiences from later-career ONN (more than 5 years of work experience). Earlier-career ONN were less familiar than later-career ONN with clinical trial participation (45% vs 79%; p=0.0315) and genetic counseling and testing (73% vs 96%; p=0.0431).
Most ONN referred yBC and mBC patients for financial, mental health, or genetic testing services. For many other services, referral patterns of yBC and mBC patients differed. Earlier-career ONN referred patients less often than later-career ONN to clinical trials (35% vs 89%; p=.0014 for yBC, and 36% vs 89%, p=.0028 for mBC).
Earlier-career ONN tended to refer mBC patients less often than yBC for genetic counseling and testing, healthy lifestyles, menopause management, and sexual health or intimacy services. In contrast, later-career ONN referred yBC and mBC patients at similar rates.
ONN reported substantial barriers to many services (but not to fatigue, menopause management, and pain management). The services for which ONN most frequently reported barriers were fertility preservation (predominantly financial and lack of programs/providers) and clinical trial services (patient understanding of value and medical jargon/health literacy barriers). ONN referred patients infrequently to some services despite reporting few barriers in contrast to prior reports of breast cancer patients' needs.
Most ONN were interested in continuing education for sexual health and intimacy but not clinical trials, treatment side effects, or pain management. Most ONN cited a need for patient materials about sexual health and intimacy and mental health issues. While most ONN were confident in their ability to address questions about breast cancer in the media, they indicated additional resources would be useful.
Understanding barriers to information and referrals is necessary to develop approaches to reduce educational gaps and lower referral barriers. Adapting efforts according to ONN career stage may be an important component for continuing education. For clinical trial participation, patient-friendly materials may help reduce barriers to referral and participation.
Citation Format: Kelly Owens, Marleah Dean, Elizabeth Bourquardez Clark, Piri Welcsh, Diane Rose, Erica Kuhn, Jessica Conaty, Robin Pugh-Yi, Susan Friedman. Needs of oncology nurse navigators serving young or metastatic breast cancer patients [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-10-11.