Wednesday, October 22, 2014
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A woman’s age and race can influence how quickly she receives surgery after a breast cancer diagnosis, U.S. researchers report.

A team at the Johns Hopkins Medical Institutions in Baltimore also found that a lengthy delay in surgery for breast cancer affects overall survival.

Factors such as socioeconomic status and the cumulative effects of a patient’s other illnesses likely contribute to breast cancer surgery delays, according to preliminary findings of the study, which looked at 1,477 breast cancer patients who had either a lumpectomy or a mastectomy at Johns Hopkins between 2000 and 2005.

The team found that the average interval from breast cancer diagnosis to surgery was six days longer for Black American women than for white women (34 days vs. 28 days). Women older than age 70 had to wait an average of 12 more days for surgery than women younger than 40. Those younger women were treated within 21 days, compared with: 28 days for patients ages 40 to 50; 31 days for women in their 50s; 29.5 days for patients ages 60 to 70; and more than 33 days for women older than 70.

Overall, the average time from diagnosis to surgery was 29 days.

Women who had to wait more than 60 days between breast cancer diagnosis and treatment were 1.8 times more likely to die from any cause compared to women who had surgery within 60 days of diagnosis, the study found.

“We think that timely treatment could make a difference in patient care,” Dr. Hae Seong Park, a research coordinator in the oncology department at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, said in a prepared statement.

The study also found the average length of time between diagnosis and surgery varied year to year. It was 24 days in 2000-01, 34 days in 2002-03, and about 30 days in 2004-05.

The stage of cancer at time of diagnosis did not seem to influence the length of time a woman had to wait until surgery.

“Although this is one factor that one might expect a time differential, we did not observe much difference,” Park said.

The researchers were especially concerned by a finding that almost 24 percent of patients didn’t receive adjuvant therapy, such as chemotherapy or hormone therapy, after they had their breast cancer surgery. Patients who had surgery more than 60 days after their diagnosis seemed to be less likely to receive adjuvant therapy, which is known to improve survival.

“Most patients should have received such treatment, but it may be that the cancer registry data did not reflect all of this information,” Park said.

The researchers also lacked information about patients’ insurance status and other data that may help explain some of the time lags between diagnosis and surgery.

“We plan to review individual patient records and collect more information to confirm what we observed and perhaps to think about interventions to provide more timely and complete care,” Park said.

The findings were expected to be presented Thursday at an American Association for Cancer Research meeting in Philadelphia.

Breastcancer.org has more about surgery for breast cancer.

Category: Health


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