Delays in Breast Cancer Surgery Linked to Increased Mortality

Timely surgery matters. Especially for women with hormone receptor–positive and HER2-negative breast cancers, delays in treatment can have life-threatening consequences.

A recent study published in Breast Cancer Research and covered by The ASCO Post found that waiting more than 42 days after diagnosis for surgery significantly increases the risk of cancer-related death in this patient group (The ASCO Post, 2025).

The Risk Grows with Each Delay

Although hormone receptor–positive and HER2-negative breast cancers are often considered slow-growing, they are not immune to the consequences of delay. The study outlined a clear progression in mortality risk based on surgical timing:

At 60 days, the risk of death increases by 21 percent
By 90 days, that risk jumps to 79 percent
At 120 days, the risk spikes to 183 percent

In contrast, more aggressive subtypes like triple-negative breast cancer showed minimal changes in mortality when surgery was delayed, which challenges some common assumptions about urgency and cancer biology.

Why Do Delays Happen?

Delays don’t always come from a lack of urgency. Sometimes, they come from patients needing time to process. They might be balancing family responsibilities, work schedules, or seeking a second opinion. Some are exploring fertility preservation before starting treatment.

Dr. Takemi Tanaka of the University of Oklahoma College of Medicine emphasized the nuance:

“While we want [patients] to understand the risk of delaying treatment, we also want them to have time to pursue egg preservation or get a second opinion” (The ASCO Post, 2025).

It's a delicate balance. Patients should never feel rushed or shamed into surgery. But they should be equipped with information that helps them make timely and informed decisions.

This Isn’t Just About Surgery

The issue of delays extends beyond the operating room. A 2020 analysis published in BMJ reviewed data from 34 studies across 17 cancer types. It found that every four-week delay in starting treatment could increase the risk of death by 6 to 8 percent (BMJ, 2020).

For patients with triple-negative breast cancer, the risks are even more pronounced. Research presented at the 2018 San Antonio Breast Cancer Symposium showed that starting chemotherapy more than 30 days after surgery raised the risk of recurrence and death by over 90 percent (The ASCO Post, 2018).

What Can Be Done

If we want to improve survival rates, we have to look at the full picture. That means reducing logistical hurdles, addressing disparities in access, and making it easier for patients to move forward with care once they’re ready.