Outcomes of Delays in Time to Treatment in Triple Negative Breast Cancer

Eastman, A. L.; Tammaro, Yolanda; Moldrem, Amy; Andrews, Valerie; Huth, James F.; Euhus, David M.; Leitch, Marilyn; Rao, Roshni

doi:10.1245/s10434-012-2835-z

Cited by 28 publications

(28 citation statements)

References 31 publications

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“…Similar to the results of a study performed by McLaughlin et al, we did not observe a difference in survival for the delay in treatment of 31‐60 days as compared to those who had treatment ≤30 days . With slightly different categories from our study, Eastman et al did not observe differing breast cancer‐specific survival between patients who had delayed treatment of 46‐90 days and ≤45 days . Smith et al studied all invasive breast cancer patients and did not see a difference in survival between those who had treatment within 0‐2, 2‐4, and 4‐6 weeks .…”

Section: Discussionsupporting

confidence: 90%

Impact of delayed treatment in women diagnosed with breast cancer: A population‐based study

Cook

et al. 2020

Cancer Medicine

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The impact of timely treatment on breast cancer‐specific survival may differ by tumor stage. We aim to study the impact of delayed first treatment on overall survival across different tumor stages. In addition, we studied the impact of delayed adjuvant treatments on survival in patients with invasive nonmetastatic breast cancer who had surgery ≤90 days postdiagnosis. This population‐based study includes 11 175 breast cancer patients, of whom, 2318 (20.7%) died (median overall survival = 7.9 years). To study the impact of delayed treatment on survival, hazard ratios and corresponding 95% confidence intervals were estimated using Cox proportional‐hazards models. The highest proportion of delayed first treatment (>30 days postdiagnosis) was in patients with noninvasive breast cancer (61%), followed by metastatic breast cancer (50%) and invasive nonmetastatic breast cancer (22%). Delayed first treatment (>90 vs ≤30 days postdiagnosis) was associated with worse overall survival in patients with invasive nonmetastatic (HR: 2.25, 95% CI 1.55‐3.28) and metastatic (HR: 2.09, 95% CI 1.66‐2.64) breast cancer. Delayed adjuvant treatment (>90 vs 31‐60 days postsurgery) was associated with worse survival in patients with invasive nonmetastatic (HR: 1.50, 95% CI 1.29‐1.74). Results for the Cox proportional‐hazards models were similar for breast cancer‐specific death. A longer time to first treatment (31‐90 days postdiagnosis) may be viable for more extensive diagnostic workup and patient‐doctor decision‐making process, without compromising survival. However, patients’ preference and anxiety status need to be considered.

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Section: Discussionsupporting

confidence: 90%

Impact of delayed treatment in women diagnosed with breast cancer: A population‐based study

Cook

et al. 2020

Cancer Medicine

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“…Furthermore, the median of 40 days from abnormal mammogram to treatment initiation in these data was greater than the 29 days reported by Bleicher et al (2012), who counted from first breast-related claim from a physician to surgery. Treatment initiation more than 84–90 days after diagnosis may be associated with reduced survival (Eastman et al, 2013; Jung et al, 2011). Additionally, in a study of low-income North Carolina women (44% non-White) McLaughlin et al (2012) found that those with an interval of greater than 60 days between diagnosis and treatment initiation had a significantly higher risk of death related to breast cancer (Hazard ratio (HR)=1.85, 95% CI, 1.04–3.27, p= .04) and a borderline increased risk of death from all causes (HR) = 1.66, 95% CI, 1.00–2.77, p= .05).…”

Section: Discussionmentioning

confidence: 99%

Time from Screening Mammography to Biopsy and from Biopsy to Breast Cancer Treatment among Black and White, Women Medicare Beneficiaries Not Participating in a Health Maintenance Organization

Selove

Kilbourne

Fadden

et al. 2016

Women's Health Issues

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“…The impact of treatment delay on survival has been investigated in highly selected populations, including women in a program targeting underserved populations (22), with Medicaid coverage(54), with triple negative breast cancer(57), receiving care at two hospitals served by the same providers following identical clinical protocols (47), and with metastatic disease (21). The results may not be generalizable, but these studies are helpful for identifying specific populations who may experience negative outcomes and the clinically relevant delay period.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Breast Cancer Treatment Delay Differ for African American and White Women

McGee

Durham

Tse

et al. 2013

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Timeliness of care may contribute to racial disparities in breast cancer mortality. African American women experience greater treatment delay than White women in most, but not all studies. Understanding these disparities is challenging since many studies lack patient-reported data and use administrative data sources that collect limited types of information. We used interview and medical record data from the Carolina Breast Cancer Study (CBCS) to identify determinants of delay and assess whether disparities exist between White and African American women (n=601). Methods The CBCS is a population-based study of North Carolina women. We investigated the association of demographic and socioeconomic characteristics, healthcare access, clinical factors, and measures of emotional and functional well-being with treatment delay. The association of race and selected characteristics with delays of >30 days were assessed using logistic regression. Results Household size, losing a job due to one’s diagnosis, and immediate reconstruction were associated with delay in the overall population and among White women. Immediate reconstruction and treatment type were associated with delay among African American women. Racial disparities in treatment delay were not evident in the overall population. In the adjusted models, African American women experienced greater delay than White women for younger age groups: odds ratio (OR), 3.34; 95% confidence interval (CI), 1.07–10.38 for ages 20–39, and OR, 3.40; 95% CI, 1.76–6.54 for ages 40–49. Conclusions Determinants of treatment delay vary by race. Racial disparities in treatment delay exist among women <50 years old. Impact Specific populations need to be targeted when identifying and addressing determinants of treatment delay.

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Outcomes of Delays in Time to Treatment in Triple Negative Breast Cancer

Abstract: In TNBC, a short delay from pathologic diagnosis to initial treatment does not appear to adversely affect survival or LRR. Appropriate time to perform evaluations such as genetic testing, imaging, or additional consultation can be taken to guide optimal treatment options.

Cited by 28 publications

References 31 publications

Impact of delayed treatment in women diagnosed with breast cancer: A population‐based study

Impact of delayed treatment in women diagnosed with breast cancer: A population‐based study

Time from Screening Mammography to Biopsy and from Biopsy to Breast Cancer Treatment among Black and White, Women Medicare Beneficiaries Not Participating in a Health Maintenance Organization

Determinants of Breast Cancer Treatment Delay Differ for African American and White Women

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