Abstract PS5-11-13: Patient navigation improves treatment compliance in women with breast cancer: A prospective observational audit from India

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Abstract Background Timely initiation of treatment is essential for optimizing breast cancer outcomes, yet in low- and middle-income countries (LMICs), barriers such as stigma, limited health literacy, and logistical challenges contribute to high treatment default rates. We assessed whether a patient navigation (PN) program could reduce default rates and improve treatment compliance in newly diagnosed breast cancer patients. Material & methods We conducted a prospective cohort audit among 391 consecutive women registered for breast cancer treatment at a tertiary care center between November 2024 and April 2025. During November-December 2024, 122 patients received standard care without navigation (NoPN cohort). From January 2025, 269 patients received structured support from trained patient navigators (PN cohort). The institutional benchmark was to plan treatment within 21 days and initiate treatment within 30 days of registration. The primary outcome was treatment default, defined as failure to initiate or complete planned treatment. Secondary outcomes included treatment planning and initiation within defined timeframes. Multivariable logistic regression was used to identify factors associated with timely treatment initiation. Results Baseline characteristics (age, education, socioeconomic status) were similar between cohorts. Overall default rates were significantly lower in the PN cohort (18.2%, 49/269) compared to NoPN (34.4%, 42/122; p=0.03). Defaults after treatment planning were also reduced (2.6% vs. 7.3%; p=0.05). Treatment initiation within 30 days was achieved in 58.7% of PN patients (158/269) versus 40.2% in NoPN (49/122; p=0.009), representing a 46% relative improvement. No significant difference was observed in achieving treatment planning within 21 days (43.8% vs. 41.8%; p=0.78). In multivariable analysis, PN was the strongest independent predictor of timely treatment initiation (OR 2.6, 95% CI 1.65-4.19), followed by higher education level (OR 1.27, 95% CI 1.02-1.58). Conclusion Patient navigation reduced default rate by 47% and increased treatment initiation within 30 days by 46%, thereby demonstrating improved treatment compliance and timely treatment initiation. Integration of navigation programs can be considered as an effective low cost strategy to enhance care delivery for breast cancer in LMIC’s. Citation Format: N. S. Goel, V. Nakkina, N. Desai, V. Noronha, R. Hawaldar, U. Mahantshetty, J. Aggarwal, R. A. Vadgaonkar, A. S. Padhy, V. Kapu, N. Annamreddi, S. K. Sahoo, R. A. Badwe. Patient navigation improves treatment compliance in women with breast cancer: A prospective observational audit from India [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 PS5-11-13.

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