Delayed Breast Cancer Care Raises Mortality Risk
Patient-attributable delays exceeding 90 days in breast cancer care were associated with a more than threefold higher risk for 2-year mortality. Living alone emerged as the only independent predictor of prolonged patient-attributable delay (PPAD), increasing the risk for delay by 88.2%.
METHODOLOGY:
This multicentre prospective cohort study included 543 symptomatic patients with breast cancer diagnosed between 2013 and 2015 across 10 hospitals in Spain's National Health System.
PPAD was defined as a delay of more than 90 days between symptom onset and the first medical consultation; overall, 77 patients experienced a PPAD.
Researchers examined associations between PPADs and clinical outcomes, including 2-year mortality, while considering sociodemographic and clinical-pathological factors.
Diagnosis confirmation involved imaging techniques, including mammography and/or ultrasound, followed by biopsy.
TAKEAWAY:
Living alone emerged as the sole independent predictor of PPAD (odds ratio [OR], 1.882; 95% CI, 1.033-3.42; P = .039).
Among patients who sought medical care within 90 days, the mortality rate was 3.2%; however, among those who experienced delays exceeding 90 days, the rate was 11.7%.
In multivariate analysis, patient-attributable delays exceeding 90 days remained a significant risk factor for 2-year mortality (OR, 3.08; 95% CI, 1.05-9.07), and advanced disease stages (stages III-IV) demonstrated the highest risk for mortality (OR, 6.78; 95% CI, 2.51-18.3).
Age remained a significant predictor of mortality (OR, 1.04; 95% CI, 1.01-1.07).
The basal-like immunophenotype demonstrated the highest risk for mortality among subtypes (OR, 7.49; 95% CI, 2.68-20.9).
IN PRACTICE:
"Our findings highlight the need for targeted interventions to raise cancer symptom awareness and address barriers faced by vulnerable groups, such as the elderly and individuals living alone, to reduce delays, improve clinical outcomes, increase survival rates, and ultimately the quality of life for patients," the authors of the study wrote.
SOURCE:
This study was led by Desirée Martín-García, Hospital Universitario Costa del Sol, Marbella, Spain. It was published online on June 24, 2025, in the European Journal of Surgical Oncology.
LIMITATIONS:
Psychosocial factors that contributed to delayed medical attention were not collected as part of the original study protocol, which limited the ability to fully understand patient motivations. This study relied on self-reported data regarding the time patients take to seek medical care, which may have introduced recall bias. Additionally, the study's focus on the Spanish healthcare context may have limited the generalisability of the findings to other settings with different healthcare systems and cultural dynamics.
DISCLOSURES:
This study received funding from the Carlos III Health Institute and Andalusian Ministry of Health, with co-funding from the European Social Fund/European Regional Development Fund. The authors declared having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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