Delays in Breast Cancer Care: The Roles of Nurse Navigation in Facilitating Timely Treatment at a Tertiary Care Hospital, Lahore

Abstract

Background: Breast cancer is the most common malignancy among women in Pakistan, with one of the highest mortality-to-incidence ratios in Asia, largely due to delayed diagnosis and treatment initiation. Sociocultural barriers, healthcare system inefficiencies, and patient-level factors exacerbate these delays, resulting in advanced-stage presentations and poor outcomes. Nurse navigation, an evidence-based strategy for coordinated oncology care, has shown promise in addressing such barriers but remains underutilized in low-resource settings. Objective: This study aimed to evaluate delays across the breast cancer care continuum and assess the effectiveness of nurse navigation in reducing diagnostic and treatment delays and improving psychosocial readiness among patients. Methods: A cross-sectional observational study was conducted among 81 breast cancer patients at a tertiary care hospital in Lahore. Participants were assigned to either a nurse navigation group receiving structured coordination and counseling services or a usual care group. Delay intervals, distress, and readiness scores were measured and analyzed using descriptive and inferential statistics. Results: Nurse navigation significantly reduced clinic-to-treatment delays (46.0 ± 32.1 vs. 78.3 ± 41.2 days, p < 0.001) and improved readiness to cope (4.45 ± 1.22 vs. 3.62 ± 1.58, p = 0.009). Delays increased with disease stage, while readiness declined, highlighting the dual logistical and psychosocial impact of navigation. Conclusion: Structured nurse navigation effectively shortens treatment delays and enhances patient preparedness, offering a scalable, patient-centered solution to improve oncology care in resource-limited healthcare systems.