ArticleJournal of cancer research and clinical oncology2021
Associated factors and outcomes of delaying adjuvant chemotherapy in breast cancer by biologic subtypes: a National Cancer Database study.
Article in Journal of cancer research and clinical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Adolescent Girls' Breast Self-Examination Practices in Eastern Region of Ghana.The breast journal · 2026Article
- Impact of adjuvant chemotherapy delay on overall survival in early-stage breast cancer: a retrospective analysis.Frontiers in oncology · 2025Article
- Dose delay, dose reduction, and early treatment discontinuation in Black and White women receiving chemotherapy for nonmetastatic breast cancer.The oncologist · 2024Article
- Adjuvant Chemotherapy in Premenopausal Patients With Hormone-Positive Breast Cancer With a Recurrence Score of 16-25: A Retrospective Analysis Using the National Cancer Database.JCO precision oncology · 2024Article
- Minimally Invasive Breast Biopsy After Neoadjuvant Systemic Treatment to Identify Breast Cancer Patients with Residual Disease for Extended Neoadjuvant Treatment: A New Concept.Annals of surgical oncology · 2024Article
- A multiparametric approach to predict triple-negative breast cancer including parameters derived from ultrafast dynamic contrast-enhanced MRI.European radiology · 2023Article
- Factors associated with diagnostic and pre-treatment intervals among breast cancer patients attending care at the Uganda Cancer Institute: A cross-sectional study.Cancer medicine · 2023Article
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5 authors.
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Abstract
purposeSeveral studies have evaluated the role of delayed initiation of adjuvant chemotherapy (AC) in breast cancer (BC), but the results have remained controversial and an optimal time has not been defined. Our aim was to determine the effect of time to starting AC from the date of surgery on survival of BC patients, based on estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status, using data from the National Cancer Database (NCDB).
methodsA total of 332,927 Stage I-III BC patients who received AC from 2010 to 2016 were analyzed. We included all ER, PR and HER2 statuses and excluded patients with stage 4 and stage 0 (DCIS) disease. The cohort was divided into five groups based on the time of initiating AC from the date of the most definitive surgery i.e., ≤ 30 days, 31-60 days, 61-90 days, 91-120 days and > 120 days. They were further divided into five subgroups based on the receptor status.
resultsHazard ratio (HR) estimates and Kaplan-Meier (KM) analysis shows that starting AC by 31-60 days shows the best survival outcome in all the subtypes, except in hormone positive/HER2 negative BC in which 31-60 days and 61-90 days have similar outcomes.
conclusionsAfter surgery for BC, it takes around 4-6 weeks to begin AC and delay in initiating the same leads to poor outcomes. Our results are particularly significant in triple-negative breast cancer (TNBC), similar to prior studies showing a benefit to starting AC as early as possible after surgery.
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