The researches find that the breast cancer should start postoperative chemotherapy, when recommended, ideally within four months of their cancer diagnosis because new study findings show that waiting longer is associated with poorer overall survival. Therefore The study, which used nationwide data; is publish as an “online first article” on the Annals of Surgical Oncology website in advance of print and was present at the American College of Surgeons (ACS) Quality and Safety Conference, concluding today in Washington, DC.

Start postoperative chemotherapy

Results of a growing number of studies suggest that timeliness in breast cancer care affects patient outcomes and could be considered a metric of the quality of care; but few guidelines exist that recommend time points for combination treatment; said the study’s senior author, Judy C. Boughey, MD, FACS, professor of surgery and vice chair for research; Mayo Clinic Department of Surgery, Rochester, Minn.

“Our study findings confirm that timely care is important for breast cancer patients ;and should be considered in their treatment plan;” Dr. Boughey said. Because The researchers looked at 172,043 records of patients with stages I to III breast cancer (has not spread outside the breast) diagnosed between 2010 and 2014 who received both surgical removal of the cancer and adjunctive (“combination”); chemotherapy anticancer drugs given afterward to try to kill any remaining microscopic cancer cells. Patients who received preoperative chemotherapy; hormone therapy, or radiation therapy were excluded from the study.

Breast cancer patients

Patients’ records came from the National Cancer Database (NCDB); which includes information on more than 70% of all newly diagnosed cancer cases in the United States. The ACS cosponsors the database with the American Cancer Society. The investigators defined a delay in chemotherapy as greater than 120 days from cancer diagnosis to the first dose of combination chemotherapy.

They based this time on a 2008 quality measure from the ACS Commission on Cancer, which recommends administering combination chemotherapy within four months to breast cancer patients under age 70 with hormone receptor negative cancers with tumors larger than 1 centimeter (0.4 inches) ;or stages IB to III. Most women with hormone receptor negative breast cancer receive chemotherapy after their operation, Dr. Boughey said.

Besides comparing overall survival rates at the last follow-up visit in patients whose time from diagnosis to chemotherapy did and did not exceed 120 days; therefore the researchers evaluated the influence of type of operation on time to chemotherapy. They analyzed groups by lumpectomy (breast conservation) versus mastectomy (breast removal), and for mastectomy; immediate breast reconstruction versus no reconstruction.