부산대학교 도서관

Background: We sought to determine factors affecting time to surgery (TTS) to identify potential modifiable factors to improve timeliness of care. Methods: Patients with clinical stage 0-3 breast cancer undergoing partial mastectomy in 2 clinical trials, conducted in ten centers across the US, were analyzed. No preoperative workup was mandated by the study; those receiving neoadjuvant therapy were excluded. Results: The median TTS among the 583 patients in this cohort was 34 days (range: 1-289). Patient age, race, tumor palpability, and genomic subtype did not influence timeliness of care defined as TTS ≤30 days. Hispanic patients less likely to have a TTS ≤30 days (P =.001). There was significant variation in TTS by surgeon (P <.001); those practicing in an academic center more likely to have TTS ≤30 days than those in a community setting (55.1% vs 19.3%, P <.001). Patients who had a preoperative ultrasound had a similar TTS to those who did not (TTS ≤30 days 41.9% vs 51.9%, respectively, P =.109), but those who had a preoperative MRI had a significantly increased TTS (TTS ≤30 days 25.0% vs 50.9%, P <.001). On multivariate analysis, patient ethnicity was no longer significantly associated with TTS ≤30 (P =.150). Rather, use of MRI (OR:.438; 95% CI:.287-.668, P <.001) and community practice type (OR:.324; 95% CI:.194-.541, P <.001) remained independent predictors of lower likelihood of TTS ≤30 days. Conclusions: Preoperative MRI significantly increases time to surgery; surgeons should consider this in deciding on its use. [ABSTRACT FROM AUTHOR]