الفهرس 
Epidemiology and Risk factorsOnly 14 pages are availabe for public view
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Abstract
Treatment timeliness has often been used as important quality metric. As treatment delay in patients with early stage cancer could be a potential for disease progression to more advanced stage where curative treatment is no longer possible.
Several studies have suggested that prolonged time to adjuvant chemotherapy was associated with worse outcomes in breast cancer. The purpose of this study was to detect the association between TTC and the outcomes of patients with breast cancer.
A total of 456 patients with breast cancer disease, which received an adjuvant chemotherapy at our clinical oncology department in 5 years from January 2011 till January 2015. Data were collected till January 2018. According to TTC, patients were divided into 3 groups. TTC was 30 days, 30-60 days and ≥60 days in group A, group B and group C respectively. Most patients laid within group A representing 195 patients (42.76%), followed by group B representing183 patients (40.13%) and group C representing 78 patients (17.11%). Median age at diagnosis was 48.00 years.
We have found that TTC was independent prognostic factor for both DFS and OS among breast cancer patients. As the patients started their adjuvant chemotherapy ≥ 60 days from definitive surgery compared with those started ≤ 30 days, suffer significantly lower survival. The same was found regarding the triple negative subgroup.
However, patients started their adjuvant chemotherapy 30 - 60 days not significantly affect their outcome when compared with those started ≤ 30 days. Also, TTC not significantly associated with survival among hormone-positive and HER2-positive patients.
Prolonged TTC (≥ 60 days) was found to have no significant association with different patients and disease characteristics like age, poor PS, NO. of comorbidities, stage and type of surgery.
There was significant association between grade, stage, T, N, ER status, HER2 status, breast cancer subtypes, receiving adjuvant radiotherapy and adjuvant hormonal therapy and both DFS and OS. However, menopausal status, type of surgery, pathological subtypes, chemotherapeutic regimens, and site of relapse did not significantly affect the survival outcome.
We concluded that starting adjuvant chemotherapy for indicated breast cancer patients especially those having triple-negative subtype should be as soon as possible preferably, not exceeding 60 days from the definitive surgery.