ArticleAnnals of surgical oncology2025
Breast Cancer Upstaging Risk and In Vivo Tumor Growth Rates Associated with Preoperative Delays.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- ASO Author Reflections: Breast Cancer Cryoablation-A Targeted, Patient-Centered Approach Surgeons Should Embrace.Annals of surgical oncology · 2026Article
- The rural-urban paradox: rethinking delays in breast cancer care.Gland surgery · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundPreoperative delay when treating breast cancer confers poorer outcomes, but growth rates and the upstaging likelihoods per delay interval remain unknown. This study evaluated upstaging risk, nodal spread, and tumor growth rates in vivo while awaiting treatment. PATIENTS AND
methodsRegistry-based data from the national cancer database was reviewed for patients treated between 2010 and 2020 at commission on cancer-accredited facilities, with nonmetastatic, noninflammatory breast cancer, undergoing surgery first.
resultsAmong 1,018,219 patients, 11.5% had primary tumoral upstaging and 14.1% had nodal upstaging. For every 30 d between diagnosis and surgery, the adjusted odds ratios (ORs) for tumor upstaging was 1.11 for ductal carcinoma in situ (DCIS) (95% CI 1.09-1.13, P < 0.0001), 1.13 for cT1 (95% CI 1.11-1.15, P < 0.0001), and 1.18 for cT2 tumors (95% CI 1.15-1.21, P < 0.0001). For invasive tumors, the adjusted 30-d ORs for upstaging in triple negative (TN) primaries were higher (P < 0.0001) at 1.21 (95% CI 1.17-1.25) than hormone receptor-positive (HR+, 1.13; 95% CI 1.12-1.15) and human epidermal growth factor 2-positive (HER2+, 1.09; 95% CI 1.04-1.13). cN0 patients had an adjusted OR for upstaging to node-positive of 1.07 (95% CI 1.06-1.08, P < 0.0001). The number of 30-d intervals for cT1a, cT1b, cT1c, and cT2 tumors to grow 1 mm was 3.95, 2.63, 2.27, and 1.92, respectively, with tumor growth faster in TN tumors (1.29) than HER2+ (4.95) or HR+ (2.35) (P < 0.0001).
conclusionsLonger delays risk greater upstaging and nodal spread, explaining the association with higher disease-specific and overall mortality in prior studies. Larger and TN tumors have larger delay-associated upstaging likelihoods and in vivo growth rates, making preoperative delays more impactful in these groups.
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