90-day delay in chemo for breast cancer as women face postcode lottery

Women face a postcode lottery over waiting times when they seek treatment for an aggressive form of breast cancer, according to new research.

Around one in five women in some areas faced waits of more than three months for potentially life-saving chemotherapy treatment for triple-negative breast cancer. The form accounts for about 15 per cent of all breast cancer diagnoses.

Women in the Midlands faced average waits of 50 days, compared to 38 days in the North West.

Triple-negative breast cancer needs to be promptly treated due to its aggressive, and surgery combined with chemotherapy is the usual treatment.

'Given that evidence of increased mortality risk as the time to chemotherapy period increases, the causes of regional disparities needs further investigation,' says Dr Pinkie Chambers of University College London, one of the research teams whose study appears in Breast Cancer Research and Treatment.

Breast cancer is the most common cancer in women and accounts for 25 per cent of all new cancer diagnoses in women.

Previous research has shown that the time between surgery and chemotherapy is important, with longer times associated with poorer survival, and early treatment prolonging the disease-free period.

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The researchers, from University College London, Nottingham University Hospital, Christie NHS Trust, and Sheffield Teaching Hospitals, analysed data on TNBC patients in different areas of England to see if there were differences in waiting times. The data covered a two years period, 2014 to 2015, and included information on time between surgery and chemotherapy for more than 1,000 women with TNBC.

The longest average periods between surgery and chemotherapy were in the Midlands, 50 days, followed by South East and South West, 49 days, East of England, 47 days, North East and Yorkshire, 45 days, London, 43 days, and North West.

London and the North West had the highest percentages of patients having chemotherapy within 30 days of surgery - 33 per cent compared to a low of 20 per cent in the Midlands.

The researchers classed delayed treatment as being waits of longer than 90 days or three months.

Patients in the East of England, Midlands and South West commissioning regions had the highest proportions of delayed treatment times, with 22 per cent of patients taking more than three months to start chemotherapy.

The Midlands had the lowest proportion of patients starting treatment within 20 days of surgery.

Just why there are differences is unclear.

'The disparities between regions warrant further investigation to identify potential gaps in service provision leading to delays within specific cancer treatment centres, and to fully understand where and for what reasons delays are occurring,' said Dr Chambers.

'Significant associations of times longer than 90 days with poorer survival outcomes have been reported.

'Research suggests that early administration of chemotherapy prolongs the disease-free period. Minimising the time period is important in achieving optimal outcomes, as this period is related to survival.'