Factors Influencing the Onset of Neoadjuvant Therapy in Breast Cancer Patients

Breast Care (Basel). 2020 Apr;15(2):182-187. doi: 10.1159/000502223. Epub 2019 Aug 29.

Abstract

Background: Time to treatment onset (TTTO) is critical in breast cancer patients receiving neoadjuvant chemotherapy (NACT). We therefore investigated possible delaying factors of therapy onset.

Methods: All patients were included who qualified for NACT in our hospital from 2015 to 2017. The time interval between core biopsy of tumor and date of therapy onset was defined as primary endpoint. Among other things, age, out- and in-patient presentation, and study or standard treatment were investigated as potentially delaying factors.

Results: We analyzed 139 patients scheduled for NACT; 90 (64.7%) received standard NACT, and 49 (35.3%) were recruited for trials. The average age was 53 years (±13.2 years). A time interval of 30.7 days (±11.8 days) was seen between diagnosis and therapy onset. Patients had a mean of 5 (±1.9) pretherapeutic presentations, 4 (±1.8) on outpatient and 1 (±0.5) on inpatient basis, being of significant influence on TTTO.

Conclusion: Any outpatient presentation extended the time interval by 2 days, inpatient presentation by 4 days. These presentations should be merged in order to minimize TTTO. Neither the site of pathology examinations, additional consultations (genetics, reproductive medicine), nor study participation delayed therapy onset.

Keywords: Breast cancer; Delaying factors; Neoadjuvant therapy; Study participation; Therapy onset.