Young Women Should Have Surgery Within 6 Weeks of Diagnosis

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Breast cancer in women and girls age 15 to 39 is rare in the United States – about 5% to 6% of breast cancers are diagnosed in women in this age group. Still, women in the 15-to-39 age group have worse survival compared to women of other ages.

After a breast cancer diagnosis, you and your doctors will put together a treatment plan specific to your unique situation. Many women diagnosed with breast cancer feel a sense of urgency about jumping right in and starting treatment very soon after diagnosis. Still, for a number of reasons, including cost, other women may put off treatment for 2 months or longer.

Researchers in California wanted to know if delays in treatment, the women’s race/ethnicity, type of insurance, or other factors were affecting survival in young women.

The study found that young women who waited longer than 6 weeks to have breast cancer surgery had worse survival than young women who had surgery earlier. Waiting longer than 6 weeks to have surgery affected survival more in black and Hispanic women than white women.

The study was published online on April 24, 2013 by the journal JAMA Surgery. Read the abstract of “Delay in Surgical Treatment and Survival After Breast Cancer Diagnosis in Young Women by Race/Ethnicity.”

The researchers looked at the records of 8,860 young women ages 15 to 39 who were diagnosed with breast cancer between 1997 and 2006. The records were part of the California Cancer Registry database.

Five-year survival rates for young women who had surgery at various times after diagnosis were:

  • 78% for women who had surgery more than 6 weeks later
  • 84% for women who had surgery with 2 weeks
  • 83% for women who had surgery within 2 to 4 weeks

Looking specifically at different groups of young women who had surgery more than 6 weeks after diagnosis, 5-year survival rates were:

  • 57% for black women
  • 74% for Hispanic women
  • 86% for white women

The type of insurance a young woman had and her socioeconomic status seemed to affect the time between diagnosis and surgery:

  • 17.8% of young women with public or no insurance had surgery more than 6 weeks after diagnosis
  • 9.5% of young women with private insurance had surgery more than 6 weeks after diagnosis
  • 17.5% of young women with low socioeconomic status had surgery more than 6 weeks after diagnosis
  • 7.7% of young women of high socioeconomic status had surgery more than 6 weeks after diagnosis

Overall:

  • having surgery more than 6 weeks after diagnosis
  • being diagnosed with estrogen-receptor-negative cancer
  • having public or no insurance
  • being diagnosed with more advanced-stage cancer

were associated with worse survival rates.

If you’re a young woman who’s been diagnosed with breast cancer, it makes sense to take the time to do some research to make sure your diagnosis is correct and your treatment plan makes sense. But as this study shows, it also makes sense to start treatment within about a month or so of being diagnosed.

If you don’t have insurance or are unemployed, you may be considering delaying your treatment because you’re worried about how you’ll pay for it. Don’t panic and don’t skip any doctor’s visits or delay your surgery. Your life may depend on it. There are resources available to help you.

Someone at your doctor’s office may be able to give you a list of organizations that offer financial assistance for breast cancer treatments and care, as well as local organizations that offer financial assistance for your practical needs, such as transportation, food, and child care.

Also, many hospitals now include patient navigators as part of the breast cancer care team. A patient navigator can help you understand and move through the health care and insurance systems. Patient navigators also can help overcome language and cultural barriers, as well as any biases based on culture, race, or age. Ask your doctor or nurse for a patient navigator recommendation.

There is only one of you and you deserve the best care possible, given in a timely manner. Don’t let any obstacles get in the way of your treatment!

For more information on how you can get financial help, visit the Breastcancer.org Paying for Your Care pages.

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