Background: Timely surgical intervention is a critical component of breast cancer treatment. However, the optimal interval for surgery remains unclear, particularly across breast cancer subtypes and in healthcare settings. This study aimed to evaluate the impact of surgical delay following breast cancer diagnosis on the 5-year overall survival in a large nationwide cohort. Methods: This retrospective cohort study analyzed data from the Korean National Health Insurance Service database, including 121 008 women who were newly diagnosed with invasive breast cancer between 2007 and 2019 and underwent surgery as their initial treatment. Time to surgery was categorized in 30-day intervals. Results: Among the 121 008 patients included, 87.7% underwent surgery within 30 days and 97.8% within 60 days of diagnosis. Compared to surgery within 30 days, no significant difference in overall survival was found for surgery within 30–59 days (hazard ratio HR, 1.00; 95% confidence interval CI, 0.92–1.10). However, delays of 60–89 days (HR, 1.54; 95% CI, 1.21–1.97) and ≥90 days (HR, 2.31; 95% CI, 1.99–2.68) were associated with significantly poorer survival. The subgroup analysis showed that this trend was most pronounced in patients receiving chemotherapy. In contrast, patients receiving endocrine therapy alone or human epidermal growth factor receptor 2-targeted therapy showed a significant decline in overall survival only after ≥90 days. Conclusion: Surgical delays beyond 60 days after breast cancer diagnosis were associated with decreased 5-year overall survival, especially among patients with more aggressive disease. Tumor biology should be considered when evaluating surgical delay in terms of prognosis.
Lee et al. (Wed,) studied this question.