Effect of Interval to Definitive Breast Surgery on Clinical Presentation and Survival in Early-Stage Invasive Breast Cancer

Vujovic, Olga; Yu, Edward; Cherian, Anil; Perera, Francisco; Dar, A. Rashid; Stitt, Larry; Hammond, A.

doi:10.1016/j.ijrobp.2008.11.049

Cited by 22 publications

(15 citation statements)

References 17 publications

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“…Previous studies have demonstrated that patients who have symptoms for >12 weeks before seeking treatment are more likely to be of advanced stage on presentation . When looking at delays to surgery after diagnosis, Vujovic and colleagues evaluated patients with pathologic T1‐T2N0 breast cancers, and found no difference in local recurrence as a function of interval to surgery. Bias may have been introduced by excluding patients who were clinically node negative on initial evaluation, but subsequently found to be node positive.…”

Section: Discussionmentioning

confidence: 99%

Timing of Breast Cancer Surgery-How Much Does It Matter?

et al. 2017

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Timing of surgical resection after breast cancer diagnosis is dependent on a variety of factors. Lengthy delays may lead to progression; however, the impact of modest delays is less clear. The aim of this study was to evaluate the impact of surgical timing on outcomes, including disease-free survival (DFS) and nodal status (NS). The cancer registry from one academic cancer hospital was retrospectively reviewed. Time from initial biopsy to surgical resection was calculated for patients with ductal carcinoma in situ (DCIS) and stage 1 and 2 invasive carcinomas. Early (0-21 days), intermediate (22-42 days), and late (43-63 days) surgery groups were evaluated for differences in NS and DFS for each cancer stage separately. A total of 3,932 patients were identified for analysis. There were no differences in DFS noted for DCIS. For stage 1, early surgery (ES) was associated with worse DFS compared to intermediate surgery (IS) (p = 0.025). There were no significant differences between ES and late surgery (LS) (p = 0.700) or IS and LS (p = 0.065). In stage II cancers, there was a significant difference in DFS in ES compared to IS (p < 0.001) and LS (p = 0.009). There was no significant difference between IS and LS (p = 0.478). Patients were more likely to undergo immediate reconstruction (p < 0.0001 for all stages) in later time-to-surgery groups, while patients in earlier groups were more likely to undergo breast conserving surgery. There was also no significant difference in NS at time of surgery in clinical stage 1 (p = 0.321) or stage 2 disease (p = 0.571). Delays of up to 60 days were not associated with worse outcomes. This study should reassure patients and surgeons that modest delays do not adversely affect breast cancer outcomes. This allows patients time to consider treatment and reconstruction options.

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Section: Discussionmentioning

confidence: 99%

Timing of Breast Cancer Surgery-How Much Does It Matter?

et al. 2017

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“…To improve wait times, and thus to reduce patient anxiety and possibly mitigate changes in patient survival, all components of the process have to be examined 15,16 . When faced with a complex system that aims to maximize throughput, it is important to consider not only the factors that affect volumes, but also those that affect efficiency.…”

Section: Discussionmentioning

confidence: 99%

Improving Patient Flow and Timeliness in the Diagnosis and Management of Breast Abnormalities: The Impact of a Rapid Diagnostic Unit

Racz

Holloway

Huang³

et al. 2016

Current Oncology

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“…Similarly, a delay between the time of diagnosis (i.e. biopsy) and surgery undoubtedly increases patient anxiety and, if longer than 3 months, may also negatively impact survival [15,16]. Surgery can, of course, cure some patients, but it also increases the risk of tumour spread, more so than biopsy.…”

Section: Discussionmentioning

confidence: 99%