Author Interviews, Breast Cancer, Chemotherapy, University Texas / 14.12.2015
Delaying Chemotherapy After Breast Cancer Surgery Can Decrease Survival
MedicalResearch.com Interview with:
Mariana Chavez Mac Gregor, MD, MSC
Assistant Professor
Breast Medical Oncology Department
Health Services Research Department
The University of Texas MD Anderson Cancer Center
Medical Research: What is the background for this study? What are the main findings?
Dr. Chavez Mac Gregor: Adjuvant chemotherapy has proven to significantly decrease the risk of recurrence among breast cancer patients, however the optimal time to start adjuvant chemotherpay remains unknown. There are biological resasons to believe that a delay in the initiation of systemic therapy can be associated with adverse outcomes. In this large study we evaluated the impact of a delay in the initiation of time to chemotherapy (TTC). We analyzed data from 24,843 patients with invasive breast cancer (stages I to III) from the California Cancer Registry and observed that compared with patients who received chemotherapy within 31 days of surgery, no adverse outcomes were associated with time to chemotherapy of 31 to 90 days of surgery. However, there was a 34 % increase in the risk of death and a 27% increase in the risk of breast cancer specific death among patients who started chemotherapy 91 or more days after surgery. In a stratified analysis according to breast cancer subtype, patients with triple-negative breast cancer, a TTC greater than 91 days was significantly associated with worse overall and breast cancer-specific survival.
In addition we evaluated factors associated with delays in time to chemotherapy (defined as > or = 91 days) and observed that many of the factors are sociodemographic in nature including low socioeconomic status, non-private insurance, and being Hispanic or African American.
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