An appropriate treatment interval does not affect the prognosis of patients with breast Cancer

Abstract

Purpose Major public health emergencies may lead to delays or alterations in the treatment of patients with breast cancer at each stage of diagnosis and treatment. How much do these delays and treatment changes affect treatment outcomes in patients with breast cancer? Methods This review summarized relevant research in the past three decades and identified the effect of delayed treatment on the prognosis of patients with breast cancer in terms of seeking medical treatment, neoadjuvant treatment, surgery, postoperative chemotherapy, radiotherapy, and targeted therapies. Results Delay in seeking medical help for ≥12 weeks affected the prognosis. Surgical treatment within 4 weeks of diagnosis did not affect patient prognosis. Starting neoadjuvant chemotherapy within 8 weeks after diagnosis, receiving surgical treatment at 8 weeks or less after the completion of neoadjuvant chemotherapy, and receiving radiotherapy 8 weeks after surgery did not affect patient prognosis. Delayed chemotherapy did not increase the risk of relapse in patients with luminal A breast cancer. Every 4 weeks of delay in the start of postoperative chemotherapy in patients with luminal B, triple-negative, or HER2-positive breast cancer treated with trastuzumab will adversely affect the prognosis. Targeted treatment delays in patients with HER2-positive breast cancer should not exceed 60 days after surgery or 4 months after diagnosis. Radiotherapy within 8 weeks after surgery did not increase the risk of recurrence in patients with early breast cancer who were not undergoing adjuvant chemotherapy. Conclusion Different treatments have different time sensitivities, and the careful evaluation and management of these delays will be helpful in minimizing the negative effects on patients.

Outcomes of a Multidisciplinary Team in the Management of Patients with Early-Stage Breast Cancer Undergoing Neoadjuvant Chemotherapy at a Community Cancer Center

“…Various factors influence the time to start of NAC including additional testing, for e.g., MRI, staging studies, and fertility preservation as indicated. Prior studies have demonstrated no impact on long term patient outcomes so long as NAC is initiated within 8 weeks of diagnosis [24][25][26].…”

Outcomes of fertility preservation before or after anticancer treatments in young breast cancer patients and survivors: a single-center retrospective study and clinical experiences

“…BC patients are usually confronted with exigent anticancer treatments and excessive delays in initiating (neo) adjuvant chemotherapy have been shown to worsen the prognosis of breast cancer [19,20]. The process of FP generally takes approximately 2-4 weeks, including the time of consultation and performing COS in appropriate timing of menstruation.…”