ArticleBreast cancer research : BCR2024
Surgical delay-associated mortality risk varies by subtype in loco-regional breast cancer patients in SEER-Medicare.
Article in Breast cancer research : BCR, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Characteristics and Outcomes of Patients With Malignancies Prior to Colorectal Cancer: A Propensity Score Matched Analysis.Journal of gastrointestinal cancer · 2026Article
- Differences in Breast Cancer Care Between Rural Women Undergoing Treatment at a Referral Center and Those Treated Locally.Annals of surgical oncology · 2026Article
- Measuring Surgical Waiting Times in Breast Cancer: Admission to Surgery Versus Biopsy Result to Surgery.Healthcare (Basel, Switzerland) · 2025Article
- Evaluating the role of sentinel lymph node biopsy in cT1-2N0M0 breast cancer: a SEER-based study.Gland surgery · 2025Article
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Abstract
Substantial evidence supports that delay of surgery after breast cancer diagnosis is associated with increased mortality risk, leading to the introduction of a new Commission on Cancer quality measure for receipt of surgery within 60 days of diagnosis for non-neoadjuvant patients. Breast cancer subtype is a critical prognostic factor and determines treatment options; however, it remains unknown whether surgical delay-associated breast cancer-specific mortality (BCSM) risk differs by subtype. This retrospective cohort study aimed to assess whether the impact of delayed surgery on survival varies by subtype (hormone [HR] + /HER2 -, HR -/HER2 -, and HER2 +) in patients with loco-regional breast cancer who received surgery as their first treatment between 2010 and 2017 using the SEER-Medicare database. Exposure of this study was continuous time to surgery from diagnostic biopsy (TTS; days) in reference to TTS = 30 days. BCSM were evaluated as flexibly dependent on continuous time (days) to surgery from diagnosis (TTS) using Fine and Gray competing-risk regression models, respectively, by HR status. Inverse propensity score-weighting was adjusted for demographic, clinical, and treatment variables impacting TTS. Adjusted BCSM risk grew with increasing TTS across all subtypes; however, the pattern and extent of the association varied. HR + /HER2 - patients exhibited the most pronounced increase in BCSM risk associated with TTS, with approximately exponential growth after 42 days, with adjusted subdistribution hazard ratios (sHR) of 1.21 (95% CI: 1.06-1.37) at TTS = 60 days, 1.79 (95% CI: 1.40-2.29) at TTS = 90 days, and 2.83 (95% CI: 1.76-4.55) at TTS = 120 days. In contrast, both HER2 + and HR -/HER2 - patients showed slower, approximately linear growth in sHR, although non-significant in HR -HER2 -.
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