Does the Time From Breast Cancer Diagnosis to Primary Surgery Impact Overall Survival? Researchers Say Yes

By: Amy MacDonald, MS
Posted: Wednesday, March 22, 2023

Identifying the optimal time for breast cancer surgery following an initial breast cancer diagnosis is important. Studies suggest that delaying surgery for too long may lead to worsening survival outcomes in patients with breast cancer, yet the exact timing past which survival is impacted is unknown.

Heather B. Neuman, MD, MS, FACS, of the University of Wisconsin School of Medicine and Public Health, Madison, and colleagues wanted to identify both the optimal time to surgery for patients with breast cancer and the factors that commonly lead to surgical delay. Published in the journal JAMA Surgery, their data demonstrate that when surgery is delayed for longer than 8 weeks postdiagnosis, survival may be impacted.

The researchers used the National Cancer Database to identify women who were diagnosed with breast cancer between 2010 and 2014 and for whom follow-up data up to 2019 were available. Included patients (n = 374,334) were adult women (aged 18 or older) diagnosed with stage I, II, or III lobular or ductal breast cancer and for whom surgery was the first course of treatment. The time to receipt of primary breast surgery and overall survival were measured.

Multivariable Cox regression analysis of the data revealed that a time to surgery of 9 weeks or more after diagnosis was associated with worse overall survival (P < .001; hazard ratio = 1.15; 95% confidence interval = 1.08–1.23). Furthermore, three main factors were found to be associated with an increased time to surgery: younger age at diagnosis, socioeconomic disadvantage (having Medicaid or no insurance), and lower neighborhood household income.

Based on these findings, the study authors recommend a best practice guideline of 8 weeks (or 56 days) from breast cancer diagnosis to primary surgery to maximize survival outcomes.

Disclosure: For full disclosures of the study authors, visit jamanetwork.com .

JAMA Surgery