Delays in Breast Cancer Treatment Associated with Poorer Survival

Delays in Breast Cancer Treatment Associated with Poorer Survival

Take-Home Messages:

• Starting chemotherapy within 120 days of a breast cancer diagnosis appears to be important for achieving the best outcomes in treatment.
• The duration of time between diagnosis and surgery had the greatest impact on the timeliness of starting chemotherapy.
• Patients undergoing immediate breast reconstruction had the most considerable delays in the time to treatment.

Kupstas, AR et. al.

Effect of Surgery Type on Time to Adjuvant Chemotherapy and Impact of Delay on Breast Cancer Survival: A National Cancer Database Analysis

Ann Surg Oncol 22 July 2019

A new national study shows that timeliness in breast cancer treatment is linked to survival. A review of the National Cancer Database found that patients with breast cancer who experienced prolonged delays in starting chemotherapy had lower rates of survival. The finding supports the importance of prompt treatment once a diagnosis of breast cancer is made.

The study was conducted by researchers at Mayo Clinic using the National Cancer Database (NCDB). The NCDB is a clinical cancer registry made up of anonymous data collected from more than 1,500 hospitals across the United States and representing over 70% of newly diagnosed cancer cases nationwide. The research team identified patients with breast cancer from 2010 to 2014 who underwent surgery followed by chemotherapy. Treatment was considered delayed if more than 120 days elapsed from the time of diagnosis to the delivery of chemotherapy.

A total of 172,043 treatment records were identified in the database. The data showed that most patients (89.5%) received chemotherapy within 120 days. However, having a delay of more than 120 days from the time of diagnosis to the start of chemotherapy was associated with worse survival.

The time from diagnosis to surgery was the most significant factor influencing the timeliness of chemotherapy. Time to surgery was shorter for patients undergoing a lumpectomy compared to a mastectomy. Among patients having a mastectomy, time to surgery was less on average if there was no combined breast reconstruction.
This information may help patients as they try to make decisions regarding options for surgery, considering the impact that these decisions may have on the timeliness of receiving chemotherapy. The results also highlight the importance of timelines of treatment as an indicator of quality in breast cancer care.