Background:Modern breast cancer (BC) treatment involves the use of multimodality therapy. Treatment delays are common and can be multifactorial. There are few studies examining the association between the duration of the time from diagnosis to completion of all acute BC treatment modalities and survival. This study is designed to determine if there is an association between time to complete treatment and survival. Study Design:A retrospective analysis was performed using data from The National Cancer Database (NCDB) to determine whether an association exists between the duration of time from diagnosis to completing all acute BC treatment (surgery, chemotherapy and radiation therapy) and survival. A second analysis was performed to determine if the association between treatment duration and survival varies by receptor status. Results:The NCDB data from BC patients diagnosed in 2010 was analyzed. The inclusion criteria included less than 80 years of age with a single cancer diagnosis, Stage I through III invasive breast cancer who required treatment with surgery, chemotherapy and radiation therapy. A total of 28,284 patients were included in the analysis. Median follow-up was 5.8 years. The order of treatment included 20,772 patients had treatment in the order of surgery, chemotherapy and radiation therapy and 7,512 patients had treatment order chemotherapy, surgery and radiation therapy. A Cox proportional hazards model was developed and identified a cut off showing the risk of delaying completion of all treatment beyond 38 weeks was associated with decrease in overall survival. This was statistically significant with an adjusted hazard Ratio of 1.21. This cut off of 38 weeks was found to be significant regardless of receptors type. The statistically significant Hazard ratios for receptor subtypes include: Triple negative (HR: 1.188, 95%CI: 1.06-1.34), ER+PR+Her2- (HR: 1.22, 95%CI: 1.09-1.36), ER-PR-Her2+ (HR: 1.29, 95%CI: 1.004-1.67) and ER+PR+Her2+ (HR: 1.32, 95%CI: 1.01-1.72). The patients with treatment duration greater than 38 weeks were comprised of 4768(63.47%) neo-adjuvant chemotherapy patients and 8191 (39.43%) of the surgery first group. Conclusion: Efforts to improve the efficiency of multimodality BC treatment and reduce treatment delays should be a priority to optimize BC patient outcomes.
Citation Format: Debra Ann Pratt, Talia Burneikis, Chao Tu, Stephen R. Grobmyer. Time to completion of breast cancer treatment and survival [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS11-34.
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