Delay of Treatment Initiation Does Not Adversely Affect Survival Outcome in Breast Cancer

Abstract

PurposePrevious studies examining the relationship between time to treatment and survival outcome in breast cancer have shown inconsistent results. The aim of this study was to analyze the overall impact of delay of treatment initiation on patient survival and to determine whether certain subgroups require more prompt initiation of treatment.Materials and MethodsThis study is a retrospective analysis of stage I-III patients who were treated in a single tertiary institution between 2005 and 2008. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to evaluate the impact of interval between diagnosis and treatment initiation in breast cancer and various subgroups.ResultsA total of 1,702 patients were included. Factors associated with longer delay of treatment initiation were diagnosis at another hospital, medical comorbidities, and procedures performed before admission for surgery. An interval between diagnosis and treatment initiation as a continuous variable or with a cutoff value of 15, 30, 45, and 60 days had no impact on disease-free survival (DFS). Subgroup analyses for hormone-responsiveness, triple-negative breast cancer, young age, clinical stage, and type of initial treatment showed no significant association between longer delay of treatment initiation and DFS.ConclusionOur results show that an interval between diagnosis and treatment initiation of 60 days or shorter does not appear to adversely affect DFS in breast cancer.

Vulnerabilidade social e câncer de mama: diferenciais no intervalo entre o diagnóstico e o tratamento em mulheres de diferentes perfis sociodemográficos

“…Delays in making diagnosis and starting treatment have been associated with worse prognosis and decreased survival 5 . Delays between disease suspicion and first appointment with a cancer specialist are often associated with pa-tient´s characteristics, such as old age, low level of education, lack of information about the disease, lack of health insurance coverage and lack of financial resources to afford medical services [7][8][9] . On the other hand, delays in the intervals between appointment, diagnosis and treatment are often related to the healthcare context 10 .…”

Coordination of Radiologic and Clinical Care Reduces the Wait Time to Breast Cancer Diagnosis

“…Some recent studies have shown benefits for decreased wait times to surgery 1,2 , but other studies have contradicted those results 3 . Yoo et al 3 reported that delay in treatment initiation did not adversely affect survival in bca, but their study looked only at a time to surgery of up to 60 days.…”

“…Studies have reported varying results for the effect of diagnostic and treatment wait times on breast cancer (bca) outcomes [1][2][3] . Systematic reviews have suggested that a benefit accrues from shortening wait times, and their conclusions recommend minimizing delays to diagnosis and treatment.…”

Time from breast cancer diagnosis to therapeutic surgery and breast cancer prognosis: A population‐based cohort study

“…Studies that have investigated the association between time from breast cancer diagnosis to first treatment and survival are inconclusive, [14][15][16][17][18][19][20][21] possibly owing to differences in calendar periods, study populations, cut-offs and starting (e.g., physician referral vs. morphological diagnosis) and end (e.g., surgery vs. neoadjuvant therapy) points for calculating delays. The two, to date, largest studies, both published by Bleicher et al 19 have found an association between increased time to surgery and worse survival.…”