Women who delay treatment for breast cancer are less likely to survive, and this is especially observed in African-Americans, Hispanics, and those of low-income.

The finding came from a new study conducted by researchers from the University of California, Irvine, who found that patients who experience a longer treatment delay time (TDT) have significantly reduced survival time compared to those with a shorter TDT. The results were published in JAMA Surgery.

Breast cancer in teens and young adults (between the ages of 15 and 39 years) make up 5 to 6% of all breast cancer cases in the U.S.

Additionally, the authors pointed out, the disease is known to be more aggressive and have a worse outcome in younger women compared to older patients.

The team of experts, led by Erlyn C. Smith, M.D., conducted a retrospective case-only study using data from the California Cancer Registry database. The investigation included 8,860 AYA breast cancer cases among adolescents and young adults who were diagnosed from 1997 to 2006.

TDT was considered the number of weeks between the date a person received a breast cancer diagnosis and the date of definitive treatment.

The experts said:

“The data presented herein provide a unique perspective that can be used to improve the outcome of breast cancer in adolescents and young adult women. Our findings demonstrate that young women with a delay in surgical treatment (>6 weeks) have shorter survival compared with those who had surgery closer to their diagnosis.”

TDT of more than six weeks after diagnosis was notably different between racial/ethnic groups:

  • Hispanic – 15.3%
  • African-American – 15.3%
  • Non-Hispanic white – 8.1%

Women shown to have TDT over 6 weeks were more likely to be those with public or no insurance (17.8%) compared to those with private insurance (9.5%).

TDT more than 6 weeks after diagnosis was also more likely to be experienced by females with low socioeconomic status (17.5%) compared to those with high socioeconomic status (7.7%).

Results also showed that the five-year survival in patients who received surgery and had TDT over 6 weeks was 80% as opposed to 90% among those with TDT less than 2 weeks.

The authors said:

“In conclusion, it is crucial to prevent further physician-related delays before and after the diagnosis of breast cancer is established to maximize the survival of these young women who are in the most productive time of their life.”

Leigh Neumayer, M.D., M.S., of the University of Utah, Salt Lake City, wrote in an invited critique, :

“In the end, in this analysis, we have continued evidence of disparities in health care that lead to decreased survival, whether the disparity is a function of race, income or delays in receiving treatment. We should all work on eliminating these disparities in an effort to improve the health of our nation.”

Previous research conducted by Dana-Farber Cancer Institute found that black and Hispanic women are less likely than whites to receive the radiation therapy routinely prescribed after surgery for early breast cancer. Another study by UC Davis researchers showed that blacks are more likely than patients from other racial and ethnic groups to die from advanced breast cancer.

Written by Sarah Glynn