Short Surgery Waits Safe
There is often, even usually, a way between diagnosis of a breast cancer and the larger surgery (wide excision/lumpectomy or mastectomy), For women who are having a mastectomy with immediate reconstruction, there may be a longer wait as it is difficult to coordiante the scheules of both the breast surgeon and the plastic surgeon. Women always worry about the safety of this delay and imagine that the cancer may be growing by the moment. My standard response is something like: "This delay is not a medical emergency, but it often is a mental health one." The wait can be torture.
From Reuters comes this review of an article in the Annals of Surgery:
From Reuters Health Information
By Amy Norton
NEW YORK (Reuters Health) May 26 - Women newly diagnosed with early stage breast cancer can take a few weeks to prepare for surgery without raising the odds that their tumor will progress, a new study suggests.
In the new study of 818 women, researchers found no evidence that a "modest" delay before surgery affected disease progression.
"Clearly, rapid treatment is desirable," said senior researcher Dr. Funda Meric-Bernstam of M.D. Anderson Cancer Center in Houston. "However," she told Reuters Health, "taking a few weeks to coordinate care is safe. It's very unlikely there will be tumor progression."
The findings, published April 13th in the Annals of Surgery, offer reassurance that women do not need to rush into surgery before they are ready. There are caveats from the current study, however. All of the women were having surgery for cancer that was confined to the breast. Also, the study was also done at a single medical center - although Dr. Meric-Bernstam said it's likely the findings can be generalized to women treated elsewhere.
Patients in the study typically had surgery three weeks after radiologic diagnosis, although the wait time ranged from as little as one day to about four months. Women who underwent breast reconstruction waited somewhat longer - about a month, on average, versus 19 days among other patients. And women total mastectomy waited longer (typically 26 days) than those only having lumpectomy (17 days).
When the researchers weighed other factors -- like the woman's age and how aggressive the cancer appeared -- they found no evidence that a longer wait for surgery raised the odds of tumor growth.
Dr. Meric-Bernstam stressed that she is not suggesting women put off surgery for any substantial amount of time. But, she said, a "modest" delay that allows their doctors to plan and coordinate their care -- and women to prepare themselves for surgery -- could potentially improve their outcomes.
Still, it's not clear whether surgical delays affect women's ultimate breast cancer survival, either negatively or positively. Larger, longer-term studies are needed, Dr. Meric-Bernstam said.
Ann Surg 2011.