Factors Contributing to Delay in Surgery in Early-stage Breast Cancer Patients

Document Type

Article

Publication Date

12-2025

Abstract

Background/Objective: Treatment delays have been associated with worse outcomes in early breast cancer patients. Commission on Cancer (CoC) recently instituted a new quality metric to measure adherence of upfront surgery being performed within sixty days of diagnosis in appropriate breast cancer patients. In this study, we aimed to identify factors potentially contributing to delay in surgery for early-stage breast cancer patients.

Methods: We conducted a retrospective cohort study of 1927 patients with Stage 0 to 3 breast cancer diagnosed and treated with upfront surgery between 2018 and 2022. We measured our average time interval (TI) to surgery, as well demographic and institutional factors including age, race, insurance status, clinical stage, and surgical options.

Results: We found that the median TI was 51 days [Range: 36, 70] at our institution. Of the 1927 subjects, 64% had a TI < 60 days and 36% had a TI > 60 days. The factors associated with increased TI were age (p < 0.001), Hispanic ethnicity (p = 0.015), insurance status (p=0.014), clinical stage (p=0.005), and those undergoing mastectomy (p< 0.001). We did not find any significant difference in those diagnosed at an outside institution or based on receptor status. There was no statistically significant difference in upgrade from clinical to pathologic stage at time of surgery between the cohorts (p=0.065) (Table).

Conclusions: Decisions leading up to definitive surgical management of breast cancer are complex. Our findings suggest that there may be further delay to surgery based on age, race and surgical options. There remains room for improvement to facilitate a higher percentage of patients achieving the goal of having surgery within 60 days of their diagnosis.

Comments

This article was published in Annals of Surgical Oncology, Volume 31, Supplement 2.

The published version is available at http://dx.doi.org/10.1245/s10434-024-15410-w.

Copyright © 2025 .

Publication Title

Annals of Surgical Oncology

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