Breast Cancer Patient Treatment Experience at a National Cancer Institute-Designated Cancer Center Before Formal Navigation Integration.

Objectives: Breast cancer accounted for over 1/3 of new US cancer diagnoses in 2024, remains the most commonly diagnosed cancer globally, and is the leading cause of cancer-related mortality among women. We evaluated breast cancer patient experience at a National Cancer Institute-designated cancer center to assess potential barriers to optimal care.

Methods: Over a 10-month period (4/1/24 to 1/31/25), eligible breast cancer patients identified in clinic visits and who self-reported diagnoses were surveyed about their experience. Each survey included a "Likelihood to Recommend" (LTR) question, scored on a 5-point Likert scale, as a proxy for satisfaction. We examined surveys from 2 service lines: medical practice (clinic visits) and outpatient oncology (radiation/infusion). We extracted demographic data from the electronic medical record. Underrepresented minorities (URMs) were defined as African American, Native American, and/or Hispanic patients. Fisher's exact test assessed differences by race and ethnicity (P<0.05).

Results: Of 15,153 patients (76.5% White, 9.9% Black, 7.6% Native American, and 94.3% non-Hispanic), 2,066 patients (13.6% response rate) completed the surveys. Response rates were significantly higher among White/non-Hispanic patients compared with URMs (P=0.0001). For outpatient oncology, patient experiences did not significantly differ by race or ethnicity. For medical practice, a trend toward significance was observed by ethnicity (P=0.07), but not by race.

Conclusions: Our retrospective cohort study found significantly lower survey response rates among URMs, which could indicate barriers to sharing patient experiences. These findings establish a baseline for comparison and support future implementation of targeted navigation programs to improve patient experience and care delivery.