The OU Health Stephenson Cancer Center found in a new study that breast cancer patients should undergo tumor removal surgery quickly after their diagnosis to avoid the spread of cancer and tumor growth.
According to a press release from OU Health, the OU Health Stephenson Cancer Center is the only National Cancer Institute-Designated Cancer Center in Oklahoma, representing the top 2 percent of cancer centers in the United States. Their study, which serves as a multidisciplinary project between students, post-doctoral fellows and professionals from various specialties, was recently published in “Annals of Surgical Oncology” and focused specifically on finding the safest amount of time to wait before having tumor removal surgery.
“The field of medicine does not really have specific guidelines about how long is a safe window of time,” Stephenson Cancer Center researcher Takemi Tanaka said in the release. “We wanted to know the time frame of when the disease progressed.”
The study was directed by OU College of Medicine students Natalie Hills and Rachel Davis, as well as Macall Leslie, a data analyst and soon-to-be masters of public health graduate from Johns Hopkins University. The team found ideally, patients shouldn’t wait more than two months before undergoing surgery.
The research team found those with breast cancers that use estrogen or progesterone for growth, which are hormone-receptor-positive, were likely to experience tumor growth and cancer spreading to the lymph nodes, depending on the length of time between diagnosis and surgery.
Patients with hormone-receptor-positive breast cancer who waited between 60 and 90 days to undergo surgery were 18 percent more likely to experience a higher-stage change in their tumor, compared to those who underwent surgery within 30 days. This number changed to 47 percent for those who waited over 90 days, with a 35 percent likelihood of cancer spreading to the lymph nodes.
According to the release, hormone-receptor-positive breast cancers typically grow much slower than hormone-receptor-negative breast cancers. The study’s findings showed this type of cancer requires little wait time between diagnosis and surgery for best outcomes.
“For a slow-progressing tumor like hormone receptor-positive disease, the speed of disease progression in a range of 60-90 days after diagnosis was much faster than we thought, and a concept of a safe time window is becoming more crucial during the COVID-19 pandemic,” Tanaka said in the release.
Researchers also found changes occurred over time among patients with hormone-receptor-negative breast cancers.
“When we find breast cancer, we need to act with deliberation moving forward, and make sure there aren’t barriers to having care done,” Dr. William Dooley, surgical oncologist at Stephenson Cancer Center, said in the release. “The most important thing for patients with hormone receptor-positive breast cancer is that the cancer be removed completely. Other parts of the treatment may be less time-dependent, but removing the tumor needs to be first and foremost in everyone’s mind.”
While the research team used seven years worth of patient outcomes from the National Cancer Database to conduct their research, those analyzed equated to about 70 percent of the U.S. population diagnosed with cancer, according to the release. This database holds information from accredited facilities by the Commision on Cancer, meaning the remaining 30 percent of unrecorded patient outcomes may represent underserved populations and facilities.
The database also underrepresents Native American people.
“We are greatly concerned about those medically underserved populations this study did not catch,” Leslie said in the release. “It is important that healthcare professions highlight medically underserved populations who are likely to have greater trouble accessing care in a timely manner.”