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Surgical delay-associated mortality risk varies by subtype in loco-regional breast cancer patients in SEER-Medicare

  • 0Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 975 NE, 10th, Oklahoma City, OK, 73104, USA.
Breast Cancer Research : Bcr +

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December 30, 2024

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December 30, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Delaying breast cancer surgery increases mortality risk, especially for hormone receptor-positive/HER2-negative subtypes. The risk grows exponentially after 42 days, highlighting the need for timely surgical intervention for all breast cancer patients.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Cancer Epidemiology

Background

  • Delayed surgery after breast cancer diagnosis is linked to increased mortality.
  • A Commission on Cancer quality measure now mandates surgery within 60 days for non-neoadjuvant cases.
  • The impact of surgical delay on breast cancer-specific mortality (BCSM) across different subtypes remains unclear.

Purpose Of The Study

  • To investigate if the association between delayed surgery and BCSM differs by breast cancer subtype.
  • To analyze the risk of BCSM in relation to time to surgery (TTS) stratified by hormone receptor (HR) and HER2 status.

Main Methods

  • Retrospective cohort study using the SEER-Medicare database (2010-2017).
  • Included patients with loco-regional breast cancer receiving surgery as the first treatment.
  • Used Fine and Gray competing-risk regression models, adjusted with inverse propensity score weighting, to evaluate BCSM risk based on TTS (days from diagnosis).

Main Results

  • Adjusted BCSM risk increased with longer TTS across all subtypes.
  • HR+/HER2- patients showed the most significant rise in BCSM risk with delayed surgery, with near-exponential growth after 42 days.
  • HER2+ and HR-/HER2- patients exhibited a slower, approximately linear increase in BCSM risk with TTS.

Conclusions

  • The impact of surgical delay on breast cancer mortality varies significantly by subtype.
  • HR+/HER2- breast cancer patients face a disproportionately higher mortality risk with delayed surgery.
  • Timely surgical intervention is crucial for optimizing survival outcomes in all breast cancer subtypes, particularly HR+/HER2-.

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