[Waiting times in breast disease clinics and psychological well-being: speedy care is better care].

OBJECTIVE: To examine the effect of diagnostic speed and the waiting time before surgery on the psychological well-being of patients in breast disease clinics.
DESIGN: Prospective cohort study
METHOD: Women with suspected breast cancer completed questionnaires about their psychological well-being before the first outpatient clinic visit (time T1: with malignancy (n = 149); without malignancy (n = 515)), shortly after diagnosis (T2: n = 96 and n = 432, respectively) and 2-3 months later (T3: with malignancy (n = 139)). Two months after the end of treatment (T4: with malignancy (n = 202)), women with breast cancer indicated which period they considered most stressful in retrospect. Diagnostic speed and the waiting time before surgery were categorized and the relation with well-being was examined. Analyses were controlled for age and cancer stage.
RESULTS: Although the period before diagnosis was experienced as stressful, diagnostic speed did not affect emotional well-being after a breast cancer diagnosis. However, a diagnosis that took a long time (> 2 weeks) did affect the emotional well-being of women who were not diagnosed with breast cancer. These women were worried and distressed for a longer period of time after diagnosis than women who received the favourable news sooner. The length of the waiting time before surgery did not affect the emotional well-being of patients thereafter: women who had surgery within two weeks were not worse or better off than women who had to wait longer. Yet, patients' emotional well-being did improve considerably after surgery, which indicates that short waiting times might shorten a period of psychological distress.
CONCLUSION: The results support a speedy diagnosis and surgery. There was no support for short waiting times having a negative psychological effect.