AVOID DELAYS IN YOUNG WOMEN WITH BREAST CANCER

Delay in Surgical Treatment and Survival After Breast Cancer Diagnosis in Young Women by Race/Ethnicity

Smith EC, Ziogas A, Anton-Culver H

JAMA Surg. 2013;148:516-523

Summary

Does the time delay between the diagnosis of breast cancer and definitive treatment in young women have any bearing on the eventual outcome? To answer this question, the authors examined data obtained from 8860 women who were younger than 40 years of age with breast cancer from 1997 to 2006. The endpoint of the study was patient survival. When there was treatment delay, defined as more than 6 weeks between diagnosis and therapy, 5-year survival was 80% compared with 90% when surgery was performed within 2 weeks of diagnosis. In multivariate analysis, a delay of more than 6 weeks increased mortality by 80% compared with prompt treatment.

Viewpoint

The results show that prompt treatment of patients in this age group, who are known to have aggressive tumors, is especially important. Treatment delay decreases 5-year survival and increases overall mortality. These results were independent of other factors known to predict survival, such as socioeconomic status, race, or tumor stage. Because the findings are based on administrative data, we do not know the reason for the delays. These women were below the recommended age for mammography; therefore, part of the delay might have been related to scheduling a confirmatory mammogram. The findings may or may not be true for the much larger group of older women with breast cancer, but for younger women, reducing the time interval between diagnosis and surgery certainly needs to be given high priority.