Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Surgery
Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Breast Cancer | Research

Time to surgery and survival in breast cancer

Authors: Doyeon An, Jihye Choi, Jaebin Lee, Jong-Yeup Kim, Seonguk Kwon, Jungeun Kim, Seunghee Lee, Seongwoo Jeon, Chungchun Lee, Suehyun Lee, Hyekyung Woo

Published in: BMC Surgery | Issue 1/2022

Login to get access

Abstract

Background

This study aimed to investigate the effect of the time from diagnosis to breast cancer surgery on breast cancer patients’ prognosis.

Methods

Of the 1900 patients diagnosed with invasive (stage 1–3) breast cancer who underwent surgery in KUH between 2012 and 2019, 279 patients were enrolled in this study. All patients, including those who received neoadjuvant chemotherapy, were classified as Model 1 subjects, and those who received immediate surgical treatment were classified as Model 2 subjects. We conducted a Cox regression analysis to identify prognostic factors of breast cancer associated with the time from diagnosis to surgery.

Results

The univariate results indicated a sharp drop in both groups’ survival rates when the time to surgery was delayed for more than 8 weeks (Model 1 p = 0.000; Model 2 p = 0.001). In the multivariate analysis, the hazard ratio (HR) of Model 1increased (HR = 6.84, 95% CI 1.06–44.25) in response to a delay in surgery of more than 8 weeks. Smoking and the American Joint Committee on Cancer (AJCC) staging system had a negative effect on breast cancer prognosis, while hormone therapy had a positive effect.

Conclusion

For all patients, a delay in breast cancer surgery of more than 8 weeks was inversely associated with survival.
Literature
1.
Kang SY, Lee SB, Kim YS, Kim Z, Kim HY, Kim HJ, Park S, Bae SY, Yoon K, Lee SK, et al. Breast cancer statistics in Korea, 2018. J Breast Cancer. 2021;24(2):123–37.CrossRefPubMedPubMedCentral
2.
3.
Bleicher RJ, Ruth K, Sigurdson ER, Beck JR, Ross E, Wong Y-N, Patel SA, Boraas M, Chang EI, Topham NS, et al. Time to surgery and breast cancer survival in the United States. JAMA Oncol. 2016;2(3):330–9.CrossRefPubMedPubMedCentral
4.
Eaglehouse YL, Georg MW, Shriver CD, Zhu K. Time-to-surgery and overall survival after breast cancer diagnosis in a universal health system. Breast Cancer Res Treat. 2019;178(2):441–50.CrossRefPubMed
5.
England N. Waiting Times for Suspected and Diagnosed Cancer Patients 2019–20 Annual Report. In. Edited by Joshua Richardson, Ana Rita Ubaldo, David Dai, McDonnell P. England; 2020.
6.
Gorin SS, Heck JE, Cheng B, Smith SJ. Delays in breast cancer diagnosis and treatment by racial/ethnic group. Arch Intern Med. 2006;166(20):2244–52.CrossRefPubMed
7.
Lohrisch C, Paltiel C, Gelmon K, Speers C, Taylor S, Barnett J, Olivotto I. Impact on survival of time from definitive surgery to initiation of adjuvant chemotherapy for early-stage breast cancer. J Clin Oncol. 2006;24:4888–94.CrossRefPubMed
8.
Sanford RA, Lei X, Barcenas CH, Mittendorf EA, Caudle AS, Valero V, Tripathy D, Giordano SH, Chavez-MacGregor M. Impact of time from completion of neoadjuvant chemotherapy to surgery on survival outcomes in breast cancer patients. Ann Surg Oncol. 2016;23(5):1515–21.CrossRefPubMed
9.
Polverini AC, Nelson RA, Marcinkowski E, Jones VC, Lai L, Mortimer JE, Taylor L, Vito C, Yim J, Kruper L. Time to treatment: measuring quality breast cancer care. Ann Surg Oncol. 2016;23(10):3392–402.CrossRefPubMed
10.
Brazda A, Estroff J, Euhus D, Leitch AM, Huth J, Andrews V, Moldrem A, Rao R. Delays in time to treatment and survival impact in breast cancer. Ann Surg Oncol. 2010;17(3):291–6.CrossRefPubMed
11.
Wagner JL, Warneke CL, Mittendorf EA, Bedrosian I, Babiera GV, Kuerer HM, Hunt KK, Yang W, Sahin AA, Meric-Bernstam F. Delays in primary surgical treatment are not associated with significant tumor size progression in breast cancer patients. Ann Surg. 2011;254(1):119–24.CrossRefPubMed
12.
13.
Shin DW, Cho J, Kim SY, Guallar E, Hwang SS, Cho B, Oh JH, Jung KW, Seo HG, Park JH. Delay to curative surgery greater than 12 weeks is associated with increased mortality in patients with colorectal and breast cancer but not lung or thyroid cancer. Ann Surg Oncol. 2013;20(8):2468–76.CrossRefPubMed
14.
15.
Cohen L, Hack TF, Moor CD, Katz J, Goss PE. The effects of type of surgery and time on psychological adjustment in women after breast cancer treatment. Ann Surg Oncol. 2000;7(6):427–34.CrossRefPubMed
16.
Masood S. Neoadjuvant chemotherapy in breast cancers. Women’s Health. 2016;12(5):480–91.PubMed
17.
18.
King TA, Morrow M. Surgical issues in patients with breast cancer receiving neoadjuvant chemotherapy. Nat Rev Clin Oncol. 2015;12(6):335–43.CrossRefPubMed
19.
Omarini C, Guaitoli G, Noventa S, Andreotti A, Gambini A, Palma E, Papi S, Tazzioli G, Balduzzi S, Dominici M, et al. Impact of time to surgery after neoadjuvant chemotherapy in operable breast cancer patients. Eur J Surg Oncol (EJSO). 2017;43(4):613–8.CrossRef
20.
Hanna TP, King WD, Thibodeau S, Jalink M, Paulin GA, Harvey-Jones E, O’Sullivan DE, Booth CM, Sullivan R, Aggarwal A. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ. 2020;371: m4087.CrossRefPubMed
21.
Sutton TL, Schlitt A, Gardiner SK, Johnson N, Garreau JR. Time to surgery following neoadjuvant chemotherapy for breast cancer impacts residual cancer burden, recurrence, and survival. J Surg Oncol. 2020;122(8):1761–9.CrossRefPubMed
22.
Weller D, Vedsted P, Rubin G, Walter FM, Emery J, Scott S, Campbell C, Andersen RS, Hamilton W, Olesen F, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012;106(7):1262–7.CrossRefPubMedPubMedCentral
23.
Koh J, Kim MJ. Introduction of a new staging system of breast cancer for radiologists: an emphasis on the prognostic stage. Korean J Radiol. 2019;20(1):69–82.CrossRefPubMed
24.
Jaiswal K, Hull M, Furniss AL, Doyle R, Gayou N, Bayliss E. Delays in diagnosis and treatment of breast cancer: a safety-net population profile. J Natl Compr Canc Netw. 2018;16(12):1451–7.CrossRefPubMed
25.
Richards MA, Smith P, Ramirez AJ, Fentiman IS, Rubens RD. The influence on survival of delay in the presentation and treatment of symptomatic breast cancer. Br J Cancer. 1999;79(5):858–64.CrossRefPubMedPubMedCentral
26.
Yun YH, Kim YA, Min YH, Park S, Won YJ, Kim DY, Choi IJ, Kim YW, Park SJ, Kim JH, et al. The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgery. Ann Oncol. 2012;23(10):2731–7.CrossRefPubMed
27.
Schott AF, Hayes DF. Defining the benefits of neoadjuvant chemotherapy for breast cancer. J Clin Oncol. 2012;30(15):1747–9.CrossRefPubMed
28.
Fisher B, Bryant J, Wolmark N, Mamounas E, Brown A, Fisher ER, Wickerham DL, Begovic M, DeCillis A, Robidoux A, et al. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 1998;16(8):2672–85.CrossRefPubMed
29.
Gaudet MM, Gapstur SM, Sun J, Diver WR, Hannan LM, Thun MJ. Active smoking and breast cancer risk: original cohort data and meta-analysis. JNCI J Natl Cancer Inst. 2013;105(8):515–25.CrossRefPubMed
30.
Holmes MD, Murin S, Chen WY, Kroenke CH, Spiegelman D, Colditz GA. Smoking and survival after breast cancer diagnosis. Int J Cancer. 2007;120(12):2672–7.CrossRefPubMed
31.
Bishop JD, Killelea BK, Chagpar AB, Horowitz NR, Lannin DR. Smoking and breast cancer recurrence after breast conservation therapy. Int J Breast Cancer. 2014;2014: 327081.CrossRefPubMedPubMedCentral
32.
Passarelli MN, Newcomb PA, Hampton JM, Trentham-Dietz A, Titus LJ, Egan KM, Baron JA, Willett WC. Cigarette smoking before and after breast cancer diagnosis: mortality from breast cancer and smoking-related diseases. J Clin Oncol. 2016;34(12):1315–22.CrossRefPubMedPubMedCentral
33.
Glass AG, Lacey JV Jr, Carreon JD, Hoover RN. Breast cancer incidence, 1980–2006: combined roles of menopausal hormone therapy, screening mammography, and estrogen receptor status. JNCI J Natl Cancer Inst. 2007;99(15):1152–61.CrossRefPubMed
34.
35.
Kim HJ, Yoon T-I, Chae HD, Kim JE, Chae EY, Yu JH, Sohn G, Ko BS, Lee JW, Son BH, et al. Concurrent gonadotropin-releasing hormone agonist administration with chemotherapy improves neoadjuvant chemotherapy responses in young premenopausal breast cancer patients. J Breast Cancer. 2015;18(4):365–70.CrossRefPubMedPubMedCentral
36.
Rastelli F, Crispino S. Factors predictive of response to hormone therapy in breast cancer. Tumori Journal. 2008;94(3):370–83.CrossRefPubMed
37.
Cheun J-H, Won J, Jung JG, Kim H-K, Han W, Lee H-B. Impact of trastuzumab on ipsilateral breast tumor recurrence for human epidermal growth factor receptor 2-positive breast cancer after breast-conserving surgery. J Breast Cancer. 2021;24(3):301–14.CrossRefPubMedPubMedCentral
38.
Li CI, Malone KE, Porter PL, Weiss NS, Tang M-TC, Cushing-Haugen KL, Daling JR. Relationship between long durations and different regimens of hormone therapy and risk of breast cancer. JAMA. 2003;289(24):3254–63.CrossRefPubMed
39.
Taroeno-Hariadi KW, Putra YR, Choridah L, Widodo I, Hardianti MS, Aryandono T. Fatty liver in hormone receptor-positive breast cancer and its impact on patient’s survival. J Breast Cancer. 2021;24(5):417–27.CrossRefPubMedPubMedCentral
40.
Lee Y, Park YR, Lee JS, Lee SB, Chung IY, Son BH, Ahn SH, Lee JW. Prescription refill gap of endocrine treatment from electronic medical records as a prognostic factor in breast cancer patients. J Breast Cancer. 2019;22(1):86–95.CrossRefPubMedPubMedCentral
Metadata
Title
Time to surgery and survival in breast cancer
Authors
Doyeon An
Jihye Choi
Jaebin Lee
Jong-Yeup Kim
Seonguk Kwon
Jungeun Kim
Seunghee Lee
Seongwoo Jeon
Chungchun Lee
Suehyun Lee
Hyekyung Woo
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01835-1

Other articles of this Issue 1/2022

BMC Surgery 1/2022 Go to the issue

Research

Posterior atlantoaxial internal fixation using Harms technique assisted by 3D-based navigation robot for treatment of atlantoaxial instability

Research

The surgical outcomes and risk factors of giant hepatic haemangiomas: a single centre experience

Research

Productivity in relation to organization of a surgical department: a retrospective observational study

Case report

The misdiagnose and treatment of a concealed kind of supernumerary nostril: a case report and review

Research

Factors associated with prolonged postoperative length of hospital stay after laparoscopic colorectal cancer resection: a secondary analysis of a randomized controlled trial

Research

Hyperthermic intraperitoneal chemotherapy for patients with gastric cancer based on laboratory tests is safe: a single Chinese center analysis