Influence of delay on survival in patients with breast cancer: a systematic review

Discusses how most patients with breast cancer are detected after symptoms occur rather than through screening, and the impact on survival of delays between the onset of symptoms and the start of treatment is controversial and cannot be studied in randomised controlled trials. Presents the results of a systematic review of observational studies worldwide of duration of symptoms and survival, finding that delays of 3-6 months are associated with lower survival rates. Concludes that these effects cannot be accounted for by lead-time bias and suggests that efforts should be made to keep delays by patients and providers to a minimum. (Original abstract - amended)