Does time to definitive treatment matter in patients with ductal carcinoma in situ?

Little is known about factors influencing time between diagnosis and definitive treatment in patients with ductal carcinoma in situ (DCIS). We sought to determine the factors influencing this delay time and implications on outcome. A retrospective review was performed of 127 patients with DCIS who were treated with definitive surgical excision at an academic center from 2000 to 2003. The mean time from diagnosis of DCIS to definitive surgical treatment was 39.5 days (range, 3 to 130 days). Age, race, tumor grade, and histopathologic features were not associated with time to definitive treatment (P > 0.05). However, patients who opted for breast-conserving surgery had a shorter time to definitive treatment compared with patients treated with mastectomy (mean time 32.9 vs 53.9 days, P < 0.001). Of patients undergoing mastectomy, those who opted for reconstruction did not have a prolonged time to treatment (55.0 vs 52.4 days, P = 0.880). Increased time between diagnosis and treatment (greater than 39.5 days) was not associated with worse prognosis in terms of overall survival (five-year actuarial survival: 93.0 vs 97.6%, P = 0.322). No demographic or histopathologic factors were associated with increased time to definitive treatment, although patients treated with mastectomy tended to have a longer diagnosis-to-treatment interval. However, the delay time was not associated with worse outcome.