Innovative Approaches Reveal Breast Cancer Growth Rates and Impact of Surgical Delays on Cancer Staging

Recent advancements in tumor analysis techniques have allowed researchers at Fox Chase Cancer Center to closely examine how quickly breast cancers develop and how delays in surgical treatment influence the stage or spread of the disease. Utilizing a novel method that assesses tumor growth through pathologic sizes—post-surgical measurements—scientists have gained unprecedented insights into tumor progression. This approach differs from traditional imaging-based clinical sizing, which can sometimes underestimate tumor extent.

The study, titled "Breast Cancer Upstaging Risk and In Vivo Tumor Growth Rates Associated With Preoperative Delays," published in the Annals of Surgical Oncology, analyzed data from over a million patients from the National Cancer Database between 2010 and 2020 who had non-metastatic, non-inflammatory breast cancer and underwent surgery first. The research emphasizes that the risk of cancer upstaging—where cancer appears more advanced at surgery than initially estimated—is relatively low, even with delays of several months. This finding provides reassurance to patients worried that postponing surgery may allow their cancer to worsen significantly.

A key discovery is that much of the observed upstaging stems from inaccuracies in initial clinical staging rather than tumor progression during delay periods. This means that improved diagnostic tools could further reduce the risk of underestimating tumor extent. The research also highlights that while delays do minimally increase the risk of disease spread, these risks tend to be small and manageable.

Lead author Richard Bleicher, MD, notes that this study offers the first insight into how quickly different breast tumors grow in real-time and how delays influence their stage. Importantly, the findings suggest that even in cases where delays occur, the overall impact on mortality remains within single digits, offering a more optimistic outlook for patients facing treatment postponements.

With these insights, clinicians can better counsel patients on the implications of treatment delays, balancing the urgency of care with other considerations. The use of more precise diagnostic tools and ongoing research will continue to refine our understanding, aiming to further minimize risks and optimize patient outcomes.