Breast MR imaging may be a possible barrier to timely surgery following cancer diagnosis, according to a new analysis published Wednesday in JAMA Surgery [1].
Longer intervals between the two healthcare events have been associated with worse survival rates. However, it’s unclear exactly how long between diagnosis and surgery is too long, University of Wisconsin experts noted.
Eight weeks appears to be the sweet spot when providers can seek out pain points that need to be addressed in the process, according to data from more than 370,000 patients. And imaging might be one area to target to shorten the window following a cancer diagnosis.
In particular, the age of 45 or younger was uniformly associated with longer wait time to surgery.
“We speculate that this is related to increased rates of magnetic resonance imaging, genetics consultation and consideration of reconstructive surgery in this group, all of which can increase time to surgery due to added preoperative appointments and scheduling constraints,” Alyssa A. Wiener, MD, with the Department of Surgery at the University of Wisconsin School of Medicine and Public Health, and co-authors wrote March 1. “Although additional imaging and consultations can push back surgery, these adjuncts are very important for treatment and decision-making.”
The analysis incorporated data from the National Cancer Database, including women diagnosed with breast cancer between 2010 to 2014 with a five-year follow-up period. Wiener et al. found that time to surgery of nine weeks or more following diagnosis was associated with worse overall survival compared to 0-4 weeks. factors associated with longer times to surgery included younger age, uninsured or Medicaid status and lower neighborhood household income, among other things.
Wiener et al. urged providers to be aware of age and how it might impact a patient’s care pathway after an MRI or other scan.
“Especially for younger patients who will spend more of their lives as survivors, taking the necessary time to make the best decisions for these patients should be fully supported while also recognizing that a system of cancer care should enable timely imaging and genetics and plastics discussions,” the authors noted. “Discouraging full use of these resources in an attempt to rush surgery could disproportionately affect these patients without conferring a meaningful survival benefit.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.