[Effect of treatment delay on survival in patients with breast cancer: a systematic review].

Background: The effect of time interval from diagnosis to treatment on survival has remained controversial. The aim of this study was to assess treatment delay in Iranian breast cancer patients and to examine its impact on overall survival and disease free survival. Materials and Methods: A historical cohort study was undertaken on breast cancer patients who were diagnosed and treated in two university hospitals between 2003 and 2013. The impact of interval to treatment defined as the time between date of pathological diagnosis, usually via open biopsy, and the date of initial therapy, either surgical or systemic was measured on overall survival and disease free survival. Prognostic factors and outcomes of the patients were analyzed using log-rank test and Cox regression model. Results: The median and mean of interval to treatment were 15 and 25.98±42.31 SD days, respectively. There was no association between the interval to treatment after a diagnosis of breast cancer and overall survival or disease free survival. In univariate analyses, statistically significant predictor for overall survival was tumor stage but not in disease free survival. In multivariate analyses, the stage II [Hazard Ratio: 0.145, 95% CI: 0.04 to 0.49, P Value: 0.002] and III [Hazard Ratio: 0.227, 95% CI: 0.08 to 0.64, P Value: 0.005] Compared with the stage IV were significantly associated with increased overall survival. Conclusion: The study suggests that delay to treatment up to two weeks has no adverse effect on overall and disease free survival. It seems that when patients diagnosed with early stage could have a waiting time longer than two weeks.