Delayed Surgical Treatment and Survival Outcome in Breast Cancer

Background: For decades, there was inconsistency regarding the association between delay in treatment initiation (surgery) and survival outcomes in breast cancer patients. Therefore, this study aimed to evaluate the impact of the interval between diagnosis and curative surgery on survival outcomes in patients diagnosed with breast cancer. Methods: This retrospective study was conducted on patients with stage I-III breast cancer referred to Imam Hossein Hospital in Tehran between 2011 and 2013. The Kaplan-Meier survival analysis and Cox proportional hazard model were performed to investigate the effect of delay in time from diagnosis to surgery and its effect on patients’ overall survival. Results: analysis of 93 patients who were treated with surgery at Imam Hossein Hospital showed the interval between diagnosis and surgery using various subgroup (cut-off value: 15, 30, and 45) had no effect on overall survival. However, surgery over 60 days after biopsy may be associated with worse overall survival (p=0.017). Cox proportional hazard model for comorbidities (HR and 95% CI: 0.2; 0.05-0.8, p<0.05) and distant metastasis (HR and 95%CI: 0.06; 0.01-0.23/p<0.0001) indicated a significant association with worse survival outcomes. Conclusion: The findings demonstrated that time intervals of 60 days or longer between biopsy and surgery adversely impact overall patient survival. The presence of comorbidities and metastasis is likely to reduce the overall survival during the specified intervals.