Time to Surgery in Breast Cancer—Is Faster Always Better?

Menée aux Etats-Unis à partir des données du registre national des cancers portant sur 373 334 patientes atteintes d'un cancer du sein (âge médian : 61 ans), cette étude évalue l'effet, sur la survie globale, du délai entre le diagnostic de la maladie et la première intervention chirurgicale

Résumé en anglais

The National Cancer Database analysis from Wiener et al highlights the complexity of identifying a single time point before which primary surgery should be completed in patients with breast cancer. There are 2 major findings: (1) the 12% of patients who had surgery more than 8 weeks after diagnosis had significantly worse overall survival and (2) patients with lower socioeconomic status had longer time to surgery. The authors therefore recommend consideration of time to surgery within 8 weeks as a quality metric for breast cancer care. We recognize the potential need for a benchmark but also the challenges of separating associations from causation in the relationship between time to surgery and outcomes. Efficiency might associate with quality, but doesn’t always ensure it.