Impact of Surgical Treatment Delay for Patients With Early-Stage Breast Cancer
Posted: Thursday, August 27, 2020
According to Elizabeth A. Mittendorf, MD, PhD, of the Dana-Farber/Brigham and Women’s Cancer Center, Boston, and colleagues, a longer time from diagnosis to surgery does not appear to impact overall survival in patients with early-stage breast cancer. The findings, which were published in the Journal of the American College of Surgeons, seem to support the safety of surgical treatment delay in these patients during the COVID-19 pandemic.
“Usually we take these patients with very small tumors directly to surgery, so it is a big change in practice to first put those patients on tamoxifen or an aromatase inhibitor,” commented initial study author Christina A. Minami, MD, MS, also of Dana-Farber, in an American College of Surgeons press release. “What we can say from our findings is that despite the delay in surgical therapy, because you were on neoadjuvant endocrine therapy, we do not think your survival will at all be impacted.”
The researchers focused on data from the National Cancer Database on 378,839 patients with ductal carcinoma in situ or early-stage estrogen receptor–positive cT1N0 or cT2N0 breast cancer who underwent surgery. The majority of patients with ductal carcinoma in situ (98.2%), cT1N0 (99.4%), or cT2N0 (99.1%) breast cancer underwent surgery within 120 days of diagnosis. Surgery was performed within 120 days of diagnosis in 59.6% and 30.9% of patients with cT1N0 and cT2N0 breast cancer who were selected for neoadjuvant endocrine therapy, respectively.
Overall, increased time to surgery appeared to be associated with a higher chance of pathologic upstaging in patients with ductal carcinoma in situ (P < .001); however, this did not seem to be true in patients with invasive cancer. Time to surgery did not appear to impact overall survival in patients with ductal carcinoma in situ or in patients selected for neoadjuvant endocrine therapy.
Disclosure: The study authors reported no conflicts of interest.
