Breast Cancer Coverage from Every Angle

Timeliness of Chemotherapy Initiation After Breast Cancer Diagnosis and Survival

By: Dana A. Elya, MS, RD, CDN
Posted: Tuesday, September 3, 2019

In a recent study, data on patients with breast cancer from the National Cancer Data Base (NCDB) were reviewed, and researchers found that chemotherapy initiated more than 120 days after a breast cancer diagnosis was associated with poorer overall survival. Additionally, surgery had the longest impact on the time of chemotherapy initiation. The study by Judy C. Boughey, MD, FACS, of the Mayo Clinic in Minnesota, and colleagues was published in the Annals of Surgical Oncology.

“Our study findings confirm that timely care is important for breast cancer patients and should be considered in their treatment plan,” Dr. Boughey said in a press release from the American College of Surgeons.

The study included 172,043 records from the NCDB of patients who had stages I to III breast cancer and received surgical removal of the cancer and adjuvant chemotherapy. The data showed the average time from cancer diagnosis to surgery was 27 days. Patients receiving breast conservation had the shortest time, at 25 days, and mastectomy with reconstruction was associated with longest time, at 35 days. The time from surgery to first chemotherapy dose was on average 43 to 44 days. The average time from diagnosis to chemotherapy was 74 days, and 89.5% of the patients started within 120 days of diagnosis.

“Compared with breast conservation,” explained Dr. Boughey, “a more extensive operation, such as mastectomy with immediate breast reconstruction, tends to have a slightly higher complication rate, which theoretically could delay initiation of postoperative chemotherapy.”

“Our findings show there is no harm in having immediate reconstruction if that’s a woman’s choice,” continued Dr Boughey. And she “recommended that hospitals evaluate their times from breast cancer diagnosis to surgical procedure to determine if they can decrease this interval.”

Disclosure: The study authors’ disclosure information may be found at

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