Putting off surgery for noninvasive breast cancer can have unintended negative consequences, according to a new study.
Delays in surgery for ductal carcinoma in situ breast cancer lead to a higher risk of invasive ductal carcinoma and a slightly lower survival rate, the study found.
“For each month of delay, there was well under a 1 percent difference in survival,” said study author Richard Bleicher, professor of surgical oncology at Fox Chase Cancer Center, in Philadelphia. “But for each month of delay, there was an approximate 1 percent increase in the finding of invasive cancer.”
DCIS, which occurs when abnormal cells form in the milk duct of the breast, is the earliest stage of breast cancer. When cancerous cells spread beyond the milk duct, it becomes invasive ductal carcinoma.
Standard treatment for DCIS is surgery, radiotherapy and endocrine therapy.
But research suggests some DCIS may never progress to invasive disease. Clinical trials are currently underway to determine whether DCIS can be observed instead of surgically removed.
This study “suggests delays in operative management of DCIS are associated with invasion and slightly worse short-term outcomes,” Bleicher said. “Since observation represents infinite delay, it suggests observation should not yet be pursued outside of a clinical trial in patients who will tolerate excision.”
The study included more than 140,600 women diagnosed between 2004 and 2014. Survival was compared with five time intervals in delays to have surgery: less than 30 days, 31-60 days, 61-90 days, 91-120 days, or 121-365 days.
Overall survival was nearly 96 percent, with a median time from diagnosis to surgery of 38 days. But each increase in diagnosis-to-surgery interval was associated with a 7.4% increase in the risk of death.
“The survival difference with a delay is small,” Bleicher said in a release. “While it’s not an emergency to get treated immediately, delays do have an effect and long delays should be avoided.”