Delay in the treatment of carcinoma of the breast

The prognostic impact of pretreatment delays was examined in an inception cohort of patients with carcinoma of the breast. Patients with delays of three months or more had a more advanced clinical stage than those with shorter delays; however, within each stage, prognosis was not affected by delay. Patients with delays of three months or more had a worse over-all prognosis than those with short delays because they had a less favorable distribution by anatomic stage and they had more adverse changes in clinical state. Nonetheless, progression of disease did not invariably occur among patients with longer delays. Patients with long delays, but without adverse changes had an excellent prognosis. The data suggests that carcinoma of the breast does not always progress as a function of time. Estimates were made of the number of patients who would benefit by reducing pretreatment delay. In this cohort, a maximum of 5 per cent of the patients were adversely affected by longer delays. Reducing delay may benefit only a small proportion of women with carcinoma of the breast.