Delay in Time to Chemo Impacts Survival in Breast Cancer

Delay in initiation of chemotherapy is associated with poorer overall survival for breast cancer, according to a study published online in the Annals of Surgical Oncology to coincide with the American College of Surgeons Quality and Safety Conference, held from July 19 to 22 in Washington, D.C.

Amanda R. Kupstas, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues examined the impact of chemotherapy delay (>120 days) on survival among patients with stage I to III breast cancer treated with surgery and adjuvant chemotherapy from 2010 to 2014.

The researchers found that 89.5 percent of 172,043 patients initiated chemotherapy within 120 days of diagnosis. The median time from diagnosis to surgery was 25 and 29 days for patients undergoing breast conservation and mastectomy, respectively; among mastectomy patients, the median time to surgery was shorter for those who underwent mastectomy without reconstruction (26 versus 35 days). Larger differences were seen between surgical groups for time from diagnosis to surgery versus time from surgery to chemotherapy. After adjustment for patient, clinical, and treatment factors, a delay of >120 days from diagnosis to chemotherapy was associated with worse overall survival (hazard ratio, 1.20) for all patients regardless of type of surgery.

"We demonstrated that time from diagnosis to surgery was in fact the time period with the greatest variability and therefore had the greatest influence on the overall time interval from diagnosis to adjuvant chemotherapy," the authors write.

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