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Margulies deep breath willowSusan got that call. You know? The one from the doctor that says, “You have cancer.”

At first, your mind goes blank.

Then fear strikes as you think not of your health, but rather of your husband being the one to take care of your children. When the fear subsides, you think about you.

Susan shares this news with her close friends who all tell her that she needs surgery right away, that the cancer cannot wait. She should go see a surgeon immediately and have surgery yesterday.

Susan schedules an appointment with a surgeon, who can see her the next day. (We surgeons are sensitive about a breast cancer diagnosis and see patients just as soon as we can.)

Susan has her consultation with the surgeon and decided to have surgery for the breast cancer. She asks her surgeon, “Can I have surgery yesterday, please?” The surgeon says, “Yes, of course. Please see my nurse to make the arrangements.” The nurse is none too happy with her surgeon.

But really, how soon does a woman newly diagnosed with breast cancer need to start definitive therapy for breast cancer? You can wait up to three months from the first symptom, which could be a mammogram, or even up to 90 days from the date of diagnosis.

Most breast cancers are slow growing and the studies that have been performed all suggest that 60 days from date of diagnosis is clearly safe and that 90 days from the date of surgery is probably safe. The three months from the first symptom is based on a study about the delays in treatment for breast cancer but did not address recurrence or survival.

There are some exceptions to consider.

If you have a Triple Negative Breast Cancer (see my blog posts: Targeted Therapies for Breast Cancer: The Silver Bullet and PARP-Inhibitors: A Cure for the Incurable?), you may want to expedite treatment to begin within 6 weeks of diagnosis as these tumors tend to be faster growing breast cancers.

Or, if you have a Stage 3 Breast Cancer and are under the age of 40, you may want to begin treatment within 6 weeks of diagnosis.

At the Knoxville Comprehensive Breast Center, we do our best to have every woman diagnosed with breast cancer begin treatment within 6 weeks after the diagnosis of breast cancer.

Treatment for breast cancer is so very important but it is more important to receive the correct, effective therapy. Sometimes this takes time to know what the correct therapy is.

Is surgery best? What type of surgery? Do you need chemotherapy? Do you need chemotherapy prior to surgery? Do you need anti-Her2 therapy? And if so, do you need it before or after surgery? So many questions and yes, we have so much time.

If you are diagnosed with breast cancer, take a deep breath, hug your kids, hold you husband’s hand and take your time. It is far better for you to have the correct treatment than to have fast treatment.

The following links are to articles which address when to begin treatment for breast cancer and may give you some assurance.

http://informahealthcare.com/doi/abs/10.3109/02841869409098427
http://link.springer.com/article/10.1007%2Fs10549-011-1662-4
http://www.ncbi.nlm.nih.gov/pubmed/3992441
http://www.karger.com/Article/Abstract/226689
http://link.springer.com/article/10.1245%2Fs10434-010-1250-6
http://archsurg.jamanetwork.com/article.aspx?articleid=1681805
http://jnci.oxfordjournals.org/content/105/2/80.full.pdf+html