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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
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Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
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  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Longitudinal Increases In Time To Surgery For Patients With Breast Cancer: A National Cohort Study

Longitudinal Increases in Time to Surgery for Patients with Breast Cancer: A National Cohort Study

Gabriella N Tortorello1, Neha Shafique2, Luke Keele2

  • 1Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. Gabriella.tortorello@pennmedicine.upenn.edu.

Annals of Surgical Oncology
|July 13, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Despite known survival risks, time to surgery for breast cancer has increased, particularly impacting marginalized groups. This trend necessitates urgent interventions to ensure equitable and timely patient care.

Area of Science:

  • Oncology
  • Health Services Research

Background:

  • Longer time to surgery (TTS) is linked to poorer survival outcomes in breast cancer patients.
  • It remains unclear if this association has led to improved promptness in care delivery.

Purpose of the Study:

  • To analyze trends in time to surgery (TTS) for breast cancer patients in the National Cancer Database.
  • To investigate if TTS has increased or decreased over time and identify factors associated with prolonged TTS.

Main Methods:

  • Utilized the National Cancer Database (2006-2019) for patients diagnosed with clinical stage 0-III breast cancer undergoing surgery as the first treatment.
  • Employed linear-by-linear trend tests and adjusted linear regression modeling to assess TTS trends and subgroup variations.

Main Results:

Keywords:
Breast cancerTime to surgeryTime to treatment

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  • Over 1.4 million patients were analyzed; median TTS increased from 26 days in 2006 to 39 days in 2019 (p < 0.001).
  • An average annual increase of 0.83 days in TTS was observed (p < 0.001).
  • Prolonged TTS was significantly associated with Black race, Hispanic ethnicity, Medicaid insurance, uninsured status, mastectomy, and reconstructive surgery.

Conclusions:

  • Time to surgery for breast cancer has steadily increased, despite evidence linking longer delays to adverse outcomes.
  • This increasing TTS may disproportionately harm marginalized patient populations.
  • Further research and interventions are crucial to guarantee timely and equitable care for all breast cancer patients.