Potential Barriers to Achieving the Commission on Cancer’s Quality Metrics for Timely Breast Cancer Care

Prompt receipt of surgery, radiotherapy, and systemic chemotherapy is critical to optimizing oncologic outcomes for patients with breast cancer.Despite advances in multidisciplinary care coordination, logistical, clinical, and socioeconomic barriers impede the real-world implementation of timely cancer care.In this issue of the Journal of the American College of Surgeons, using data from National Cancer Database (NCDB; 2018 to 2022), Nataliansyah and colleagues 1 report on associations between patient and facility socioeconomic status (SES) and timeliness of 3 Commission on Cancer (CoC) breast cancer quality measures: (1) breast-conserving surgery less than or equal to 60 days of diagnosis for those undergoing upfront operation, (2) initiation of adjuvant systemic chemotherapy less than or equal to 120 days of diagnosis for women age younger than 70 years with T1cN or stage IB to III hormone receptor negative disease, and (3) adjuvant radiotherapy initiation less than or equal to 60 days after definitive operation for those undergoing breast-conserving operation for stage I to III disease who do not receive adjuvant systemic chemotherapy or immunotherapy. 2 Patients who were of Black race, lacked insurance, and lacked higherlevel education all had increased time to treatment.Although patients treated at facilities classified as low SES had higher odds of timely operation, they had lower odds of timely receipt of adjuvant systemic chemotherapy and radiotherapy.