Survival rate lower for surgery nine weeks or more after breast cancer diagnosis


Time from breast cancer diagnosis to surgery of nine weeks or longer is associated with worse overall survival, according to a study published online March 1 in JAMA Surgery.

Alyssa A. Wiener, M.D., from the University of Wisconsin School of Medicine and Public Health in Madison, and colleagues examined the association between time from breast cancer diagnosis to surgery and overall survival among women diagnosed with breast cancer from 2010 to 2014 with five-year follow-up. The final cohort included 373,334 patients aged 18 years or older with stage I to III ductal or lobular breast cancer who underwent surgery as the first line of treatment.

The researchers found that compared with surgery between zero and four weeks after diagnosis, time to surgery of nine weeks or later after diagnosis was associated with worse overall survival (hazard ratio, 1.15). Factors associated with longer times to surgery included younger age (adjusted odds ratios, 1.32, 1.64, and 1.58 for patients aged 45 years or younger undergoing surgery 31 to 60, 61 to 74, and more than 74 days after diagnosis, respectively, versus one to 30 days from diagnosis); uninsured or Medicaid status (adjusted odds ratios for patients with Medicaid, 1.35, 2.13, and 3.42, respectively); and lower household income (adjusted odds ratio for patients with household income <$38,000, 1.35, 1.21, and 1.53, respectively).

“Based on our findings, we recommend surgery before eight weeks from breast cancer diagnosis,” the authors write. “This time interval does not appear to have a detrimental association with cancer outcomes and allows for multidisciplinary care.”

One author is a founder of and stockowner in Elucent Medical.

More information:
Alyssa A. Wiener et al, Reexamining Time From Breast Cancer Diagnosis to Primary Breast Surgery, JAMA Surgery (2023). DOI: 10.1001/jamasurg.2022.8388

Rita A. Mukhtar et al, Time to Surgery in Breast Cancer—Is Faster Always Better?, JAMA Surgery (2023). DOI: 10.1001/jamasurg.2022.8395

Journal information:
JAMA Surgery

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