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Surgical wait times increased in Medicare patients with breast cancer
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The length of time Medicare patients with breast cancer had to wait between their first visit with a physician and surgery increased by more than 10 days between 1992 and 2005, according to study results.
Prior research has indicated that delays in surgical waiting time after breast cancer diagnosis may cause anxiety and affect outcomes.
Medicare patients with data between 1992 and 2005 and who had not been treated with neoadjuvant chemotherapy were eligible for the current analysis.
Richard J. Bleicher, MD, of the department of surgical oncology at Fox Chase Cancer Center in Philadelphia, and colleagues conducted the investigation to determine the interval from presentation to surgery among a cohort of 72,586 women with nonmetastatic invasive breast cancer.
The median interval between first visit and surgery was 29 days. That interval increased from 21 days in 1992 to 32 days in 2005.
The delay was longer in women (29 days) than men (24 days; P<.001). Researchers also observed longer delays between first visit and surgery for younger patients (29 days; P<.001); blacks (37 days; P<.001) and Hispanics (each 37 days; P<.001); patients in the Northeast (33 days; P<.001), and patients who live in large metropolitan areas (32 days; P<.001).
Patients who underwent breast conservation surgery had an adjusted median delay of 28 days. Mastectomy was associated with an adjusted median delay of 30 days, and simultaneous reconstruction with these two procedures added another 12 days.
Specific additional delays also were associated with preoperative components to breast cancer treatment such as imaging modalities, biopsy type and clinician visits.
“If such increases continue, periodic assessment may be required to rule out detrimental effects on outcomes,” the researchers wrote.
“I don’t believe the delays we’re seeing here are problematic, [but] we’re clearly going to need to keep an eye on it because if those delays keep increasing, they may become problematic,” Bleicher said in a press release.
Disclosure: The researchers report no relevant financial disclosures.
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