Timing of Surgical Management for Breast Cancer

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • The timing of surgical management for breast cancer patients:
    • Has been evaluated in multiple retrospective studies
  • Patients are increasingly more anxious regarding a breast cancer diagnosis and are wanting more immediate intervention despite the delays which are possible from increased use of reconstructive procedures
  • Multiple studies have aimed to determine the optimal timing of surgical intervention in breast cancer as it pertains to overall and survival outcomes
  • One of the most recent retrospective reviews performed in 2023 was conducted by Weiner et al:
    • This study evaluated whether there was a correlation between time from a breast cancer diagnosis to surgical intervention and the patient’s overall survival:
      • Data from the NCDB database was utilized from 2010 to 2014 and included female patients who were 18 and older with stage I to III breast cancer who underwent upfront surgery
      • This review found that patients undergoing surgery greater than 8 weeks from diagnosis:
        • Had a poorer overall survival when compared to patients who underwent surgical intervention less than 8 weeks from diagnosis
      • The review concluded that time to surgery of 8 weeks or less:
        • Should be used as the quality metric for breast cancer patients
      • Data analysis from this same study revealed that while time to surgery may portend a worse survival when greater than 8 weeks:
        • The most impactful driver of breast cancer survival outcomes still remains tumor characteristics to include:
          • Loco-regional spread and nodal status
          • Tumor size and receptor subtypes
  • The European Union of Breast Cancer Specialists published quality indicators for breast cancer patients in 2010 to include timeliness of surgery as a recommended but not mandatory quality metric:
    • This recommendation specifically endorsed that patients who were planned for upfront surgery:
      • Should receive surgical intervention within 6 weeks of biopsy confirmation of breast cancer:
        • With a minimum of 75% of patients falling within the 6-week timeframe and a goal that 90% or greater of patients with breast cancer will have surgical treatment within this timeframe
  • References
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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