6572 Background: Disparities between U.S. population groups in cancer incidence, treatment and outcome have been well documented. There is little information available about effective means of eliminating these differences utilizing patient navigator programs. Through the evaluation of the processes and outcomes of breast cancer care at a safety net hospital, this study attempts to better define, the impact of a patient navigation program. Methods: This was a retrospective case series analysis. Navigator program was established in January 2000. Eligible women with a diagnosis of breast cancer between January 1, 1997 and December 31, 1999, were included in the standard management (SM) group. Women with breast cancer diagnosed between January 1, 2000 and December 31, 2003, were included in the Patient Navigator (PN) group. The time interval from symptom presentation or abnormal mammogram to first access to treatment which includes surgery, chemotherapy or radiation was obtained. Statistical data was analyzed using SPSS software. Results: Three hundred and thirty five women were diagnosed between January 1, 1997 and December 31, 2003. Thirteen patients were ineligible leaving a final study population of 322 women; 103 women in the SM group, and 219 women in the PN group. The time interval from initial presentation to the date of definitive therapy was shorter during the period of time when PN was available with a median time to first treatment was 9 days shorter (42 days in SM group compared to 33 days in PN group). The stage of cancer at the time of presentation and treatment was not different between the two groups. One potential impact of PN program was dramatic increase in proportion of insured patients. Overall survival was not influenced by the PN program. Conclusions: The PN program at this safety net hospital did not influence the stage of presentation or the overall survival of women with breast cancer. There was a modest decrease in the time between initial presentation and definitive therapy. The utility of navigator programs is likely to vary with each institution and the program should be modified to respond to the unique needs of the patients being served. No significant financial relationships to disclose.
Pituitary Metastasis in HER-2 positive breast cancer with initial presentation of hypernatremia: Two case reports
