Generally speaking, surgery for breast cancer is ideally done from 31 to 90 days after diagnosis. This allows time for thorough diagnostic testing and decision making without affecting outlook.

Surgery is a very common treatment for breast cancer. According to the American Cancer Society (ACS), most people with nonmetastatic breast cancer will have some type of surgery, often along with other types of treatment.

If you or a loved one has recently received a diagnosis of breast cancer, you may be wondering exactly how urgent surgery is. It’s possible that delays in surgery can affect breast cancer outcomes.

In this article, we discuss how time to surgery affects the outcome of breast cancer. We also cover the goals of breast cancer surgery as well as additional factors that can affect a person’s outlook.

There’s always going to be some amount of time between diagnosis and surgery. This is because a healthcare team will do preoperative tests to better understand your cancer. It can also sometimes take time to schedule your surgery.

There’s no standard for how soon you should have surgery after a breast cancer diagnosis.

However, it’s possible that delays in having surgery can affect breast cancer outcomes. A longer delay could potentially lead to the growth or progression of your cancer.

A 2016 study looked at time to surgery in 94,544 people with breast cancer. Time to surgery was divided up into five 3-month intervals:

  • less than 30 days
  • 31 to 60 days
  • 61 to 90 days
  • 91 to 120 days
  • 121 to 180 days

The researchers found that overall survival was lower with each increasing delay interval. They noted that while preoperative evaluations are important, a shorter time to surgery should be pursued, if possible.

How long is too long?

Because time to surgery can affect outlook, you may be wondering how long is too long to wait. Generally speaking, it’s ideal to keep the time to surgery as short as you can while considering necessary preoperative tests and decision making.

Research on this topic is conflicting. For example, studies from 2017 and 2022 found that the outlook for people with breast cancer wasn’t affected until time to surgery surpassed 60 days.

A 2018 review examined studies on the time to treatment and how outlook was affected. Based on their review, the author noted that a time from diagnosis to surgery of less than 90 days was optimal for outlook.

A 2020 study that looked at the effects of time to first breast cancer treatment supports this. It concluded that a longer time to first treatment, defined as 31 to 90 days, would promote more thorough diagnostic testing and decision making without compromising survival.

The overall goals of surgery for breast cancer are to remove the tumor and to prevent the cancer from coming back (recurring).

The type of surgery that’s recommended for you can depend on several factors, including:

  • the specific type of breast cancer you have
  • the breast cancer’s genetic profile
  • the extent of the cancer
  • how aggressive the cancer is (grade)
  • whether there’s one tumor or multiple tumors
  • the size of the tumor(s)
  • the presence or absence of certain biomarkers
  • your previous medical history, age, and overall health
  • your personal preference

There are two general types of breast cancer surgery:

  • Breast-conserving surgery (BCS). BCS involves the removal of the tumor as well as some surrounding breast tissue. The remaining breast tissue is preserved. BCS is typically followed by radiation therapy.
  • Mastectomy. A mastectomy involves the removal of the entire breast and sometimes surrounding tissues as well.

To kill any remaining cancer cells and help prevent a recurrence, you may receive additional breast cancer treatments either alone or in combination after your surgery. This is called adjuvant therapy and may involve:

It’s also important to note that you may also receive one or more of these breast cancer treatments prior to your surgery to help make a tumor smaller. This is called neoadjuvant therapy.

Receiving a diagnosis of breast cancer and preparing for surgery can be overwhelming. It’s important to get all the facts about the types of surgery that are recommended for you.

Here are some questions to ask your care team.

  1. What type or types of surgery do you recommend for my cancer? Why?
  2. Can I choose not to have surgery? If so, what are my treatment options?
  3. If I choose to have surgery, how soon do I need to have it?
  4. Will I need to receive any treatment prior to my surgery? If so, what are the options?
  5. Will lymph nodes be removed as a part of my surgery?
  6. How long will the surgery last?
  7. Will I need to stay in the hospital after my surgery? If so, for how long?
  8. How will I feel after my surgery? Will I need to take medications for pain?
  9. How does this surgery affect how treatable my cancer is and the likelihood of cancer coming back in the future?
  10. How will my breasts look and feel after the surgery? Will I have a scar, and if so, what will it look like?
  11. What are the potential risks and side effects of this surgery?
  12. What’s the typical recovery time for this type of surgery?
  13. Will physical therapy be recommended as a part of my recovery?
  14. Is there anything I can do to help prepare for my surgery and recovery period?
  15. When will I see you for follow-up visits?
  16. Will I need to receive additional treatments after my surgery? If so, what do you recommend?
  17. Depending on the type of procedure, is breast reconstruction surgery an option for me?
  18. Will my insurance cover the costs of the surgery and breast reconstruction?

There’s a lot of information to cover when it comes to breast cancer surgery. It may be helpful to take notes during your appointments so that you can reference them later.

While time to surgery can affect the outlook for people with breast cancer, there are many other factors that are important as well. These include:

Every person undergoing treatment for breast cancer is different. A healthcare team will consider all of the above factors to help give you an idea of your outlook.

Is one type of surgery more common?

Many people with breast cancer have BCS, especially if the cancer is in an early stage. However, rates of mastectomy, specifically contralateral mastectomy, are increasing, especially in younger people.

A contralateral mastectomy is when the breast with the cancer and the other breast, which doesn’t have cancer, are both removed. According to the ACS, this increasing trend in contralateral mastectomies may be occurring because of:

  • concerns about cancer recurrence
  • reservations about receiving radiation therapy
  • a desire for breast symmetry

Is a mastectomy better than BCS?

Older research from 2002 found that people with early stage breast cancer who had a mastectomy and those who had BCS had a similar long-term overall survival.

More recent studies have found that BCS with radiation therapy is associated with better survival in this group.

However, at the end of the day, the type of surgery you opt for is based on many factors, including the characteristics of your cancer, your overall health, and your personal preference.

Should you get a second opinion before having surgery?

It’s important to gather all the facts before making treatment decisions for breast cancer. A second opinion can help you make an informed decision as well as consider potential treatment alternatives and their risks and benefits.

The ACS notes that you often have time to consider your treatment options and make decisions about them. However, decisions need to be made more quickly for aggressive cancers. A healthcare team can give you a better idea of the timeframe.

How long does treatment for breast cancer typically take?

The time it takes to treat breast cancer can vary greatly based on several factors. These include the type and stage of cancer, the type or types of treatment recommended, and how the cancer responds to the treatment.

Once you’ve decided on a treatment plan, a healthcare team can give you an idea of what to expect as far as timing goes.

Surgery is one of the main treatment options for breast cancer. The timing between diagnosis and surgery can affect the outlook for people with breast cancer.

Generally speaking, it’s ideal to have your surgery as shortly after your diagnosis as is reasonable. Some research has shown that delays of less than 90 days shouldn’t compromise outlook.

Making treatment decisions after a breast cancer diagnosis can feel overwhelming, but it’s vital to get as much information as you can. As such, don’t hesitate to raise any questions or concerns to a healthcare team as they come up.