ArticleAnnals of surgical oncology2026
Targeted Multidisciplinary Continuous Improvement Process Reduces Time to Breast Cancer Surgery with Immediate Reconstruction.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundBreast surgery with immediate breast reconstruction (IBR) is associated with delays in definitive surgery and adjuvant therapy. We evaluated a multiphase quality improvement (QI) initiative to reduce time to treatment (TTT) for patients undergoing upfront surgery with IBR.
methodsThis retrospective cohort study included patients with newly diagnosed breast cancer undergoing upfront surgery at a single institution between January 2022 and June 2025. Patients with metastatic disease, neoadjuvant therapy, or first treatment outside this institution were excluded. The QI initiative comprised three phases: (1) weekly multidisciplinary team huddle; (2) standardized communication protocol; and (3) OR alignment between breast and plastic surgery. Primary outcome was median TTT. Time to treatment for non-IBR patients was tracked concurrently as a balancing metric.
resultsA total of 3,324 patients met inclusion criteria; 1,100 (33.1%) underwent surgery with IBR and 2,224 (66.9%) without. The cohort was predominantly early-stage (82.8% cTis/T1). Median TTT declined from 56 to 36 days in the IBR group and from 41 to 29 days in the non-IBR group (both P < 0.001). The proportion waiting longer than 45 days declined from 67.4 to 27.3% for IBR and from 40.5 to 22.9% for non-IBR (both P < 0.001). Only the IBR group demonstrated statistically significant improvement through Phase 3 (P < 0.001), while the non-IBR group plateaued after Phase 2.
conclusionsA targeted multidisciplinary QI initiative meaningfully reduced TTT for breast cancer patients undergoing upfront surgery with IBR without delaying non-IBR patients. Operating room (OR) alignment was the pivotal intervention, highlighting the importance of system-level coordination between breast and plastic surgery.
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