Using a novel method to analyze tumor growth rates, researchers at Fox Chase Cancer Center have conducted an in-depth study on how fast breast cancers grow and how surgical delays affect cancer staging. This study provides new insights into tumor progression between diagnosis and surgery.
“It’s the first study ever to use pathologic tumor sizes to determine how fast tumors of different sizes and traits grow in the patient while they’re waiting for treatment,” said Bleicher, lead author on the study at Fox Chase.
Pathologic tumor size is determined after surgical removal, while clinical size is assessed through imaging before surgery. The study found that upstaging rates due to delays are relatively small, consistent with previous data showing only single-digit mortality risks even with months-long delays.
“Many patients fear that delays in care will allow their cancer to grow and spread beyond the point of cure. This study provides the most comprehensive evaluation of how treatment delays may affect the likelihood that a tumor will be upstaged or be at a more advanced stage at the time of surgery than initially estimated at diagnosis,” Bleicher said.
The research team used differences between initial clinical and pathologic tumor sizes to calculate growth and upstaging risk. The method accounts for inaccuracies in clinical staging, offering a more accurate assessment of associated risks.
Data from over one million patients treated between 2010 and 2020 was utilized. These patients had non-metastatic, non-inflammatory breast cancer undergoing surgery as their first treatment.
“Interestingly, a significant proportion of the observed upstaging is not from tumor progression, but from the inaccuracy of clinical staging,” Bleicher noted.
“The findings in this study expand our knowledge and offer new data to help counsel individuals diagnosed with breast cancer,” he added.
“We may not be able to stop time, but armed with this new knowledge, we can use it more wisely, empowering patients to ensure that they feel urgency and not fear.”
The study was published in the Annals of Surgical Oncology.
