Evaluation of the effect of the time between the diagnosis of breast cancer and the start of treatment on survival and recurrence rates

Evaluation of the effect of the time between the diagnosis of breast cancer and the start of treatment on survival and recurrence rates The aim of this study was to evaluate the effect of the time elapsed between the time of cancer diagnosis and the time of surgery on patient survival and recurrence of the disease in patients diagnosed with breast cancer. This cross-sectional study was conducted by retrospectively evaluating the files of 167 patients who met the study criteria and underwent surgery for breast cancer between January 1, 2010 and December 31, 2021 at the Department of General Surgery, Mersin University Medical Faculty Health Research and Application Hospital. The mean age of the patients was 49.78 ± 10.83 years. Family history was present in 21.6%, DCIS component in 21.0%, multifocality in 21.0%, lymphovascular invasion in 56.3% and perineural invasion in 37.1%. The pathologic stage was stage I in 24.6%, stage II in 62.3% and stage III in 13.2% of the cases. The mean delay between diagnosis and surgery was 38.81 ± 49.06 days and the mean total follow-up was 54.31 ± 26.22 months. Chemotherapy was administered to 90.4%, radiotherapy to 66.5%, hormone therapy to 76.6%, recurrence occurred in 10.8% and 13.8% died. Compared to the non-recurrence group, >50 mm tumors (10.1% vs 27.8%, respectively, p = 0.031), lymphovascular invasion (53.0% vs 83.3%, respectively, p = 0.014), perineural invasion (34% vs 34.0%, respectively), perineural invasion (34% vs 83.3%, respectively), 2% vs 61.1%, p = 0.026), tumor at the surgical margin (3.4% vs 16.7%, p = 0.042, respectively) and radiotherapy treatment (63.1% vs 94.4%, p = 0.008, respectively) were statistically significantly more frequent in the recurrence group. Compared to cases without recurrence, the frequency of lymph node staging N0 was statistically significantly lower (44.3% vs 16.7%) and N3 was higher (6.0% vs 27.8%, p = 0.004) in cases with recurrence. Moreover, stage IIIA (4.7% vs 16.7%), stage IIIB (3.4% vs 22.2%, p = 0.005) and stage III (10.7% vs 33.3%, p = 0.025) tumors were statistically significantly more common in patients with recurrence. Compared with cases without recurrence, the delay time was statistically significantly shorter among those with recurrence (p = 0.030). The cut-off for delay time for recurrence was found to be 24 days. Those delayed for 24 or fewer days were more likely to recurrence. The area under the curve (AUC=0.656, p=0.028) is statistically significant. Overall survival was 135.063 ± 3.993 (95% CI: 127.236 - 142.890) months. Patients with pathologic stage III and patients with recurrence had a statistically significant shorter survival time (p<0.001). In conclusion, the frequency of recurrence was higher in patients with a shorter delay period, whereas there was no significant correlation between survival time and delay period. In addition, the presence of recurrence and an increase in the pathologic stage were found to decrease the survival time.