A study recently published in the British Journal of Cancer suggests that the social and economic conditions of where a person lives can play a major role in how quickly they undergo surgery to treat breast cancer after diagnosis.
Researchers found that delays were significantly more common among patients living in socially disadvantaged areas and among Black and Hispanic women, highlighting persistent inequities in cancer care.
The study analyzed data from more than 13,500 women treated for invasive breast cancer in New York City between 2007 and 2021. Using electronic health records from multiple academic medical centers, researchers examined how neighborhood-level social drivers of health, including income, education, unemployment, and the proportion of non-English speakers, were linked to delays in surgery. Delayed treatment was defined as more than 60 days after diagnosis, a threshold widely used as a benchmark for timely cancer care.
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Overall, delays occurred in 10.7% of patients undergoing lumpectomy and 25.3% of those undergoing mastectomy. Across both surgery types, people living in areas with higher unemployment and more residents who did not speak English were more likely to experience delays. In contrast, those with higher-income and better-educated neighborhoods were less likely to face long waits.
The results also showed pronounced racial and ethnic disparities. Non-Hispanic Black patients had more than double the odds of delayed lumpectomy compared with White patients, while Hispanic patients also faced significantly higher odds of delay. Similar patterns were seen for mastectomy. Even after adjusting for age, body mass index and other health conditions, the disparities persisted, suggesting broader structural factors may be influencing access to timely care.
The researchers noted that surgery is often the first treatment offered after a breast cancer diagnosis, and previous studies have linked longer waits to poorer survival outcomes. National guidelines recommend starting treatment within 60 days, making delays a critical quality-of-care issue.
Overall, the study authors stated that the findings underscore the importance of addressing social drivers of health in cancer care planning.
“Future studies should aim to disentangle patient, provider, and system-level factors driving these delays and identify targeted interventions that can streamline preoperative workflows without compromising quality or equity of care,” the authors wrote.
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