Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
Breast Cancer Res Treat. 2023 Nov;202(1):129-137. doi: 10.1007/s10549-023-07049-0. Epub 2023 Aug 16.
High-risk breast pathology is a breast cancer risk factor for which timely treatment is crucial. Nurse navigation programs have been implemented to minimize delays in patient care. This study evaluated nurse navigation in terms of timeliness to surgery for patients with high-risk breast pathology.
This was a single-institution, retrospective review of patients with identified high-risk breast pathology undergoing lumpectomy between January 2017 and June 2019. Patients were stratified into cohorts based on periods with and without nurse navigation. Preoperative and postoperative time to care as well as demographic and tumor characteristics were compared using univariate and multivariate analysis.
100 patients had assigned nurse navigators and 29 patients did not. Nurse navigation was associated with reduced time from referral to date of surgery (DOS) by 16.9 days (p = 0.003). Patients > 75 years had a shorter time to first appointment (p = 0.03), and patients with Medicare insurance had a reduced time from referral to DOS (p = 0.005). 20% of all patients were upstaged to cancer on final surgical pathology.
Nurse navigation was significantly associated with decreased time to care for patients with high-risk breast pathology undergoing lumpectomy. We recommend nurse navigation programs as part of a comprehensive approach for patients with high-risk breast pathology.
高危乳腺病理学是乳腺癌的一个危险因素，及时治疗至关重要。护士导航计划已经实施，以尽量减少患者护理的延迟。本研究评估了护士导航在高危乳腺病理学患者手术及时性方面的效果。
这是一项单机构、回顾性研究，纳入了 2017 年 1 月至 2019 年 6 月期间接受保乳手术的高危乳腺病理患者。患者根据有无护士导航分为两组。使用单因素和多因素分析比较术前和术后护理时间以及人口统计学和肿瘤特征。
100 例患者有指定的护士导航员，29 例患者没有。护士导航与手术日期（DOS）前的 referral 时间减少了 16.9 天（p = 0.003）相关。>75 岁的患者首次就诊时间更短（p = 0.03），而 Medicare 保险患者 referral 到 DOS 的时间缩短（p = 0.005）。所有患者中有 20%最终手术病理分期升级为癌症。
护士导航与接受保乳手术的高危乳腺病理学患者的护理时间缩短显著相关。我们建议将护士导航计划作为高危乳腺病理学患者综合治疗的一部分。
