Researchers find that most Medicare patients wait weeks before breast cancer surgery

November 19, 2012, Fox Chase Cancer Center

Although patients may feel anxious waiting weeks from the time of their first doctor visit to evaluate their breast until they have breast cancer surgery, new findings from Fox Chase Cancer Center show that these waits are typical in the United States. Results were published on Monday, November 19 in the Journal of Clinical Oncology.

Looking at data collected from more than 72,000 diagnosed with non-, researchers—led by Richard J. Bleicher, M.D., attending surgeon and director of the Breast Fellowship Program at Fox Chase—found that, in 2005, half of the underwent at least 32 days after first consulting their doctor about their breast problem. This is an increase from 1992, when half of the patients waited no more than 21 days.

"For many patients, it can take a month or more from the time they first see their doctor to evaluate their breast concern, make a diagnosis, and get them to the ," says Bleicher. "So if a woman learns that her surgery date is weeks after her evaluation, where she was found to have a breast cancer, she should know this length of time is typical, and should not be concerned."

"Although this interval may sound alarming at first, it does not appear to have a detrimental effect on outcomes. We don't have the outcomes data for this group of patients yet, but we have seen improvements in survival over the past few decades in breast cancer overall." Bleicher adds.

Before this study, Bleicher explains, it was unclear how long people were actually waiting for surgery and how the surgery type and workup affected that wait. Experts had data from individual institutions, but nothing that captured nationwide. So when patients got anxious hearing their surgery was weeks away, doctors were unable to tell them whether such were longer than the norm, and thus potentially dangerous.

"It's not clear why people are waiting longer for surgery," says Bleicher. Now that patients have access to more information about cancer, they may take longer to make decisions about surgery; alternatively, a larger patient population could be filling operating rooms, making it harder to schedule surgeries. Indeed, patients undergoing more complicated procedures—such as mastectomy with breast reconstruction—waited longer than average.

Longer delays were also seen in patients who received certain types of biopsies and imaging. This suggests that part of the increase in wait time may stem from greater use of a wider variety of current tools to detect and image the tumors before surgery, says Bleicher. This may also explain why patients may be living longer, even though the time from presentation to their doctor until surgery steadily increased from 1992 to 2005.

"Patients should be aware that even though feels like an emergency needing to be addressed tomorrow, it doesn't have to be dealt with in a matter of days," says Bleicher. "These results should reassure women that, if they are not in the operating room tomorrow, that's typical."

He adds that the findings apply only to patients receiving Medicare, and wait times may differ for those with private insurance or no insurance at all.

Even within the Medicare population, there was some variation – wait times were longer for women (29 days, versus 24 days for men), younger patients (29 days), blacks and Hispanics (37 days each), people living in large metropolitan areas and the northeast (32 and 33 days, respectively).

"Although these results suggest that doctors and shouldn't be concerned about small delays in getting to surgery, we need to continue to monitor how long people are waiting," says Bleicher. "Researchers must ensure that this time interval doesn't increase dramatically or start to affect outcomes in certain patient groups, particularly those who already wait longer than the average."

Explore further: Researchers find no disparities in imaging before breast cancer surgery

Related Stories

Researchers find no disparities in imaging before breast cancer surgery

May 17, 2012
If racial and ethnic disparities in breast cancer exist, they are not due to differences in the use of imaging to assess the extent of tumors before surgery, according to new findings that will be presented by Fox Chase Cancer ...

Breast cancer patients face increasing number of imaging visits before surgery

December 9, 2011
Breast cancer patients frequently undergo imaging like mammograms or ultrasounds between their first breast cancer-related doctor visit and surgery to remove the tumor. Evaluations of these scans help physicians understand ...

Recurring cancers in women with a history of breast cancer differ from the original tumors

May 18, 2011
When women with a history of breast cancer learn they have breast cancer again, one of the first questions they and their doctors ask is: Has my cancer come back, or is this a new case? Now, new data from Fox Chase Cancer ...

Most breast cancer patients do not have breast reconstruction surgery

October 20, 2011
Only seven per cent of female breast cancer patients opt for breast reconstruction surgery.

Recommended for you

Researchers develop swallowable test to detect pre-cancerous Barrett's esophagus

January 17, 2018
Investigators at Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center have developed a simple, swallowable test for early detection of Barrett's esophagus that offers promise ...

Scientists zoom in to watch DNA code being read

January 17, 2018
Scientists have unveiled incredible images of how the DNA code is read and interpreted—revealing new detail about one of the fundamental processes of life.

Dulling cancer therapy's double-edged sword

January 17, 2018
Researchers have discovered that killing cancer cells can actually have the unintended effect of fueling the proliferation of residual, living cancer cells, ultimately leading to aggressive tumor progression.

Presurgical targeted therapy delays relapse of high-risk stage 3 melanoma

January 17, 2018
A pair of targeted therapies given before and after surgery for melanoma produced at least a six-fold increase in time to progression compared to standard-of-care surgery for patients with stage 3 disease, researchers at ...

T-cells engineered to outsmart tumors induce clinical responses in relapsed Hodgkin lymphoma

January 16, 2018
WASHINGTON-(Jan. 16, 2018)-Tumors have come up with ingenious strategies that enable them to evade detection and destruction by the immune system. So, a research team that includes Children's National Health System clinician-researchers ...

Researchers identify new treatment target for melanoma

January 16, 2018
Researchers in the Perelman School of Medicine at the University of Pennsylvania have identified a new therapeutic target for the treatment of melanoma. For decades, research has associated female sex and a history of previous ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.