The influence on survival of delay in the treatment initiation of screening detected non-symptomatic breast cancer

Abstract

We aimed to determine whether the detection-to-treatment interval of non-symptomatic breast cancer is associated with factors that can predict survival outcomes. A retrospective review of the Breast Surgery Department Database at Peking Union Medical College Hospital (PUMCH) was performed, and a total of 1084 non-symptomatic invasive breast cancer patients were included. The findings revealed that detection-to-treatment interval was significantly longer for women who were older (p = 0.001), lived in rural areas (p = 0.024), had lower education (p = 0.024), and had detection in other institutions (p = 0.006). Other sociodemographic and clinicopathological characteristics were not associated to longer interval. A median follow-up of 35 months (range: 6-60 months) was carried out and a long delay at more than 90 days did not significantly decrease the DFS (univariate, P = 0.232; multivariate, P = 0.088). For triple negative breast cancer, there was a worse DFS if the interval was longer than 90 days both in multivariate analysis (hazard ratio [HR] = 3.40; 95% CI, 1.12-10.35; P = 0.031) and univariate analysis (HR = 2.86; 95% CI, 1.03-7.91; P = 0.042). Further studies on care before initial treatment of non-symptomatic breast cancers are warranted.

Figure 1

Kaplan-Meier survival curves of disease-free survival (DFS) by interval between screening detection and treatment initiation (≤90 days vs. >90 days).