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Assessing Time to Surgery in Asian Women With Breast Cancer: A National Cancer Database Analysis
Kshitij S Gaur1, Meghan M Conroy1, Lisa E Rein1
1Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Journal of Surgical Oncology
|August 10, 2026
Summary
Southeast Asian women faced the longest delays in breast cancer surgery, while Pacific Islander women experienced worse survival outcomes. Disaggregated analysis revealed critical disparities within Asian American and Pacific Islander populations.
Area of Science:
- Oncology
- Health Disparities
- Health Services Research
Background:
- Time to surgery (TTS) over 60 days is a quality metric linked to poorer breast cancer outcomes.
- Asian American and Pacific Islander (AAPI) women are often grouped, masking significant subgroup differences.
- Understanding these disparities is crucial for equitable cancer care.
Purpose of the Study:
- To investigate variations in TTS among distinct AAPI subgroups.
- To determine the impact of TTS on overall survival (OS) within these subgroups.
- To highlight disparities in breast cancer care for AAPI women.
Main Methods:
- Retrospective cohort study using the National Cancer Database (NCDB).
- Categorization of AAPI patients into East Asian (EA), Southeast Asian (SEA), South Asian (SA), and Pacific Islander (PI) groups.
- Analysis of delayed TTS (>60 days) and its association with OS using Cox regression.
Main Results:
- Southeast Asian women showed the highest proportion of delayed TTS (29%).
- Delayed TTS was significantly associated with worse overall survival across all AAPI subgroups (p < 0.001).
- Pacific Islander women had the poorest overall survival (HR 1.45).
Conclusions:
- Disaggregated analysis is essential for identifying subgroup disparities in breast cancer care.
- Southeast Asian women face significant delays in surgical treatment.
- Pacific Islander women experience worse survival, necessitating targeted interventions.