Breast Cancer Coverage from Every Angle

Does Treatment Delay Differentially Impact Overall Survival Across Breast Cancer Phenotypes?

By: Nahae Kim, MPH
Posted: Wednesday, January 22, 2020

The effect of patient survival based on treatment delays does not seem to differ across breast cancer phenotypes, according to recent findings published in the Annals of Surgical Oncology. Richard J. Bleicher, MD, FACS, of Fox Chase Cancer Center, Philadelphia, and colleagues suggest that urgency between the time of diagnosis and surgery or chemotherapy also appears to be similar among subtypes of breast cancer.

“There need not be panic about starting treatment more quickly [for] triple-negative tumors as versus others,” Dr. Bleicher stated in a Fox Chase Cancer Center press release. “We found that delays do matter and do have a negative effect on outcomes in patients with triple-negative disease. But this also occurred with the other types, and there was no difference in the effect of the delay between the three phenotypes of breast cancers.”

An observational study was conducted from data retrieved from the National Cancer Database, including 351,087 women with invasive breast cancer who were diagnosed between 2010 and 2014. Among the breast cancer phenotypes, 10.5% were triple-negative, 77.9% were hormone receptor–positive, and 11.7% were HER2-positive. Delays investigated were days from diagnosis to surgery, surgery to chemotherapy, and diagnosis to chemotherapy. The median times between diagnosis and surgery or chemotherapy were 29.9 and 72.7 days for patients with triple-negative disease, 31.6 and 78 days for patients with hormone receptor–positive disease, and 31.5 and 74.4 days for patients with HER-2 positive disease.

The study authors attributed the expedited times for patients with triple-negative disease to existing concerns about its poorer prognosis. However, delays across all breast cancer phenotypes negatively affected overall survival, with no differences among the phenotypes. Furthermore, the investigators noted that the timing of treatment should not be an indication when administering neoadjuvant chemotherapy for triple-negative tumors.

Disclosure: For full disclosures of the study authors, visit

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