Grant: Fellowship - PA: CIHR/Rx&D - CAMO Research Program

In breast cancer, chemotherapy after surgery has an important role. Studies have shown that adjuvant chemotherapy in certain patients could impact survival by reducing the risk of relapse and death which helped establish the role of adjuvant chemotherapy in high risk breast cancer. Despite decades of research addressing the question of what constitutes the best chemotherapy, there is a striking lack of information regarding when best to give the chemotherapy after surgery. Other researchers looked at this question in 2006 and suggested that the survival is better when chemotherapy is given up to 12 weeks after surgery compared to wait times longer than 12 weeks. There is an urgent need to examine this question again. We believe that waiting time makes a difference and that we need to further study this question using modern chemotherapy treatments. We are planning two projects. The first project will involves an analysis of information that was collected in 3 studies that tested different types of chemotherapy in patients with early breast cancer. We will see what impact waiting time has on survival. We will conduct another project that examines how long it takes patients in Ontario to start chemotherapy after their diagnosis and initial surgery. We will look at the wait times for specific events such as the referral to the cancer centre; being seen by a cancer specialist and receiving the first dose of chemotherapy. We will conduct this project with other cancer centers in Ontario. On the basis of these projects, we hope to provide information regarding what is an appropriate time to wait until start of chemotherapy and how the health care system might be improved to make the wait time as short as possible.