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- Eriksson, LouiseKarolinska Institutet (författare)
Time from breast cancer diagnosis to therapeutic surgery and breast cancer prognosis : A population-based cohort study
- Artikel/kapitelEngelska2018
Förlag, utgivningsår, omfång ...
- 2018-04-17
- Stockholm :John Wiley & Sons,2018
- printrdacarrier
Nummerbeteckningar
- LIBRIS-ID:oai:DiVA.org:uu-362024
- ISSN:1097-0215
- 10616/47143hdl
- https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-362024URI
- https://doi.org/10.1002/ijc.31411DOI
- http://hdl.handle.net/10616/47143URI
- http://kipublications.ki.se/Default.aspx?queryparsed=id:138838876URI
Kompletterande språkuppgifter
- Språk:engelska
- Sammanfattning på:engelska
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Anmärkningar
- Theoretically, time from breast cancer diagnosis to therapeutic surgery should affect survival. However, it is unclear whether this holds true in a modern healthcare setting in which breast cancer surgery is carried out within weeks to months of diagnosis. This is a population- and register-based study of all women diagnosed with invasive breast cancer in the Stockholm-Gotland healthcare region in Sweden, 2001-2008, and who were initially operated. Follow-up of vital status ended 2014. 7,017 women were included in analysis. Our main outcome was overall survival. Main analyses were carried out using Cox proportional hazards models. We adjusted for likely confounders and stratified on mode of detection, tumor size and lymph node metastasis. We found that a longer interval between date of morphological diagnosis and therapeutic surgery was associated with a poorer prognosis. Assuming a linear association, the hazard rate of death from all causes increased by 1.011 (95% CI 1.006-1.017) per day. Comparing, for example, surgery 6 weeks after diagnosis to surgery 3 weeks after diagnosis, thereby confers a 1.26-fold increased hazard rate. The increase in hazard rate associated with surgical delay was strongest in women with largest tumors. Whilst there was a clear association between delays and survival in women without lymph node metastasis, the association may be attenuated in subgroups with increasing number of lymph node metastases. We found no evidence of an interaction between time to surgery and mode of detection. In conclusion, unwarranted delays to primary treatment of breast cancer should be avoided. What's new? Theoretically, an increase in the interval between breast-cancer diagnosis and therapeutic surgery should affect survival, but it is uncertain whether that holds true in a modern healthcare setting. In this prospective study, the authors found that even fairly short delays (on the order of days or weeks) from diagnosis to surgery are associated with decreased survival. These results suggest that the time between diagnosis and therapeutic surgery should be kept as short as possible without hampering diagnostic work-up and preoperative patient optimization.
Ämnesord och genrebeteckningar
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
- breast cancer
- surgery
- time factors
- survival
- cancer epidemiology
Biuppslag (personer, institutioner, konferenser, titlar ...)
- Bergh, JonasKarolinska Institutet (författare)
- Humphreys, KeithKarolinska Institutet (författare)
- Wärnberg, FredrikUppsala universitet,Endokrinkirurgi(Swepub:uu)fredwarn (författare)
- Törnberg, SvenKarolinska Institutet (författare)
- Czene, KamilaKarolinska Institutet (författare)
- Karolinska InstitutetEndokrinkirurgi (creator_code:org_t)
- Karolinska Institutet
- Karolinska Institutet
Sammanhörande titlar
- Ingår i:International Journal of CancerStockholm : John Wiley & Sons143:5, s. 1093-11040020-71361097-0215
Internetlänk
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- International Journal of Cancer (Sök värdpublikationen i LIBRIS)
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