Navigate is necessary, otherwise the journey tires you: the social worker's intervention in the navigation of patients with breast cancer

Abstract

The Patient Navigation Program (PNP) originated in the United States following the recognition of barriers that hindered access to health services for low-income Black women, particularly in the interval between diagnosis and the initiation of breast cancer treatment. The program aimed to reduce such barriers and promote timely and effective treatment initiation. In Brazil, in addition to Law No. 14,450/2022, which established the National Patient Navigation Program for Malignant Breast Neoplasms within the Unified Health System (SUS), Law No. 14,758/2023—regulated by Ordinance GM/MS No. 6,592/2025—instituted the National Cancer Prevention and Control Policy and created the National Patient Navigation Program for Individuals Diagnosed with Cancer. This regulatory framework defines navigation as individualized follow-up aimed at identifying and overcoming barriers throughout the continuum of care, from diagnostic suspicion to treatment continuity, supported by navigator professionals responsible for guiding, monitoring, and facilitating access to health services. Objective: To analyze the available evidence in the scientific literature regarding the role of navigators in the care of patients with breast cancer and to identify how the intervention of social worker navigators is described and addressed in these publications. Method: A scoping review was conducted based on the Joanna Briggs Institute (JBI) methodology, with searches carried out in databases such as Pubmed/Medline, Lilacs, and Scopus, as well as grey literature through Capes Journals and Google Scholar. Documents with full texts available online in Portuguese and English, addressing the research question and published between 2010 and 2023, were included. Results/Discussion: After analysis, twelve studies were selected for full-text review. Qualitative analysis was performed using thematic categorization of the main contributions and limitations identified in the studies. The findings indicate that most PNP experiences in Brazil involve nurses as navigators, while the role of social workers remains incipient. Conclusion: The results reveal a low level of scientific production regarding social workers’ interventions within the PNP. Therefore, there is an urgent need for further studies to consolidate evidence on the contribution of this professional to the quality of care, access, and adherence to oncological treatment.