Assessment of Breast Cancer Treatment Delay Impact on Prognosis and Survival: a Look at the Evidence from Systematic Analysis of the Literature.

Abstract

Introduction: Breast cancer has remained the most commonly diagnosed disease among women globally. Despite the advancement in biomedical sciences leading to improve survival outcomes, some patients endure longer wait periods prior to initiation of treatment.

Objective: To elucidate the impact of treatment delay on breast cancer patient's quality of life and survivorship. Second was to determine the optimal length of time (delay) between breast cancer diagnosis and start of first treatment in order to improve prognosis and general health and well-being of survivors.

Methods: Systematic search of the literature was conducted across five electronic databases: Pub Med, EMBASE, CINAHL, Scopus and Science Direct as well as the reference list of all articles retrieved.

Results: A total of 33 articles were included in the evidence based systematic review, which comprised of 255,366 observations. The results of the studies were categorized under five main themes as: study characteristics, cancer staging and classification, treatment delay time definition and interval, treatment regimen classification and delay impact on quality of life and survival. Analyzed wait times from diagnosis to the initiation of first therapy ranged from 7 days to a period of over 180 days. Combinations of standardized treatment including loco-regional radiotherapy, systemic chemotherapy surgery as well as hormonal therapy were examined. Even though some of the studies showed mixed results, overall, findings indicated that early detection, diagnosis and initiation of treatment within 90 days increase survival.

Conclusions: Evidence revealed that delaying the initiation of treatment for breast cancer more than 90 days after diagnosis has a detrimental effect on disease free and overall well-being of survivors.