Factors Affecting Time to Surgery in Breast Cancer Patients.
Am Surg
; 88(4): 648-652, 2022 Apr.
Article
in En
| MEDLINE
| ID: mdl-34732082
ABSTRACT
BACKGROUND:
We sought to determine factors affecting time to surgery (TTS) to identify potential modifiable factors to improve timeliness of care.METHODS:
Patients with clinical stage 0-3 breast cancer undergoing partial mastectomy in 2 clinical trials, conducted in ten centers across the US, were analyzed. No preoperative workup was mandated by the study; those receiving neoadjuvant therapy were excluded.RESULTS:
The median TTS among the 583 patients in this cohort was 34 days (range 1-289). Patient age, race, tumor palpability, and genomic subtype did not influence timeliness of care defined as TTS ≤30 days. Hispanic patients less likely to have a TTS ≤30 days (P = .001). There was significant variation in TTS by surgeon (P < .001); those practicing in an academic center more likely to have TTS ≤30 days than those in a community setting (55.1% vs 19.3%, P < .001). Patients who had a preoperative ultrasound had a similar TTS to those who did not (TTS ≤30 days 41.9% vs 51.9%, respectively, P = .109), but those who had a preoperative MRI had a significantly increased TTS (TTS ≤30 days 25.0% vs 50.9%, P < .001). On multivariate analysis, patient ethnicity was no longer significantly associated with TTS ≤30 (P = .150). Rather, use of MRI (OR .438; 95% CI .287-.668, P < .001) and community practice type (OR .324; 95% CI .194-.541, P < .001) remained independent predictors of lower likelihood of TTS ≤30 days.CONCLUSIONS:
Preoperative MRI significantly increases time to surgery; surgeons should consider this in deciding on its use.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Breast Neoplasms
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
Language:
En
Journal:
Am Surg
Year:
2022
Document type:
Article
Affiliation country: