Do Delays Impact Breast Cancer Survival?

👉An emerging quality indicator for breast cancer care is timeliness of care delivery and efficiency, which is a concern for patients as well as for clinicians.

👉Several recent studies have suggested detrimental effects of long delays between breast cancer diagnosis and starting adjuvant therapy.

👉The American College of Surgeons Commission on Cancer has defined receipt of systemic chemotherapy within 120 days of diagnosis of hormone receptor-negative cancer as a quality metric for patients younger than 70 years.

👉The goals of this analysis of data from the National Cancer Database were to examine the effect of surgical treatment type on time to adjuvant chemotherapy and the effect of treatment delay on survival among patients with stage I to III breast cancer treated with both surgery and adjuvant chemotherapy from 2010 to 2014.

👉A delay in starting adjuvant chemotherapy after surgery for breast cancer can adversely affect survival, say US researchers, who found that the type of surgery performed plays a significant role in that delay.

👉In particular, the team found that for women who underwent reconstruction after mastectomy, there was more likely to be a delay before starting adjuvant chemotherapy that was longer than the 120 days currently recommended.

👉This, crucially, could have an effect on survival, they warn, because a delay from diagnosis to chemotherapy of more than 120 days was associated with a 29% reduction in overall survival.

👉The research was published online in the Annals of Surgical Oncology on July 22.

👉Overall, the results were encouraging, in that 89.5% of women who are recommended chemotherapy postoperatively do get it within 120 days of their diagnosis, but there is still room for improvement – Dr. Arrangoiz

👉The authors of the study recommended that hospitals examine whether they can reduce the interval from breast cancer diagnosis to surgical procedure.

👉The delay, could be a result of poor access to care, longer wait times for a second opinion, and the coordination between surgeons needed to organize immediate breast reconstruction.

👉The authors point out not only that timeliness in the delivery of cancer care is a concern for patients and physicians on a subjective level but also that there is “a growing body of data” to suggest it affects outcomes.

👉Although previous studies were inconclusive or found no correlation between the timing of breast cancer care and overall survival, more recent studies have shown that long delays have detrimental effects.

👉This led to a recommendation by the American College of Surgeons’ Commission on Cancer to include the administration of systemic chemotherapy within 120 days of diagnosis as a quality metric for the treatment of some women with breast cancer.