Delay of Treatment Initiation Does Not Adversely Affect Survival Outcome in Breast Cancer.
OBJECTIVE
Previous studies examining the relationship between time to treatment and survival outcome in breast cancer have shown inconsistent results. The aim of this study was to analyze the overall impact of delay of treatment initiation on patient survival and to determine whether certain subgroups require more prompt initiation of treatment.


METHODS
This study is a retrospective analysis of stage I-III patients who were treated in a single tertiary institution between 2005 and 2008. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to evaluate the impact of interval between diagnosis and treatment initiation in breast cancer and various subgroups.


RESULTS
A total of 1,702 patients were included. Factors associated with longer delay of treatment initiation were diagnosis at another hospital, medical comorbidities, and procedures performed before admission for surgery. An interval between diagnosis and treatment initiation as a continuous variable or with a cutoff value of 15, 30, 45, and 60 days had no impact on disease-free survival (DFS). Subgroup analyses for hormone-responsiveness, triple-negative breast cancer, young age, clinical stage, and type of initial treatment showed no significant association between longer delay of treatment initiation and DFS.


CONCLUSIONS
Our results show that an interval between diagnosis and treatment initiation of 60 days or shorter does not appear to adversely affect DFS in breast cancer.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Tae-Kyung
TK
Yoo
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.|Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Wonshik
W
Han
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.|Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Hyeong-Gon
HG
Moon
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Jisun
J
Kim
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Jun Woo
JW
Lee
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Min Kyoon
MK
Kim
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Eunshin
E
Lee
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Jongjin
J
Kim
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.|Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Dong-Young
DY
Noh
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
Breast neoplasms; Survival rate; Time-to-treatment