{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T16:44:03Z","timestamp":1792341843091,"version":"4.4.0"},"reference-count":64,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast cancer (BC) in young patients is often identified at later stages, which can result in poor prognosis. It is important to investigate the factors influencing care delays and how delays affect outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study included women aged \u226440 years at diagnosis of stage 0\u2013IV BC in the Young Women\u2019s Breast Cancer Study enrolled between 2006 and 2016. Associations between patient and tumor factors and presentation delay (first symptom to provider visit, \u226590 days), diagnostic delay (presentation to diagnosis, \u226590 days), and treatment delay (diagnosis to treatment, \u226560 days) were estimated via logistic regression. Multivariable logistic models for delays were constructed via backward selection (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0\u2264\u00a0.05 retained). Multivariable Cox proportional hazards models tested the association between delays and disease\u2010free survival (DFS) and overall survival (OS). Analyses were stratified by tumor subtype and stage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1071 women, there were 153 presentation, 120 diagnostic, and 228 treatment delays. In multivariable models, lower annual income was associated with higher odds of presentation delay, whereas pregnancy at diagnosis, family history of BC, and triple\u2010negative (TN) subtype were associated with lower odds. In HER2\u2010positive luminal B tumors, presentation delays were associated with later stage (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001). Odds of diagnostic delay were higher for younger patients and lower for those with TN tumors. Patients with more aggressive tumor subtypes were less likely to have treatment delays. Delays were not associated with DFS or OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort of young patients with BC, demographic and tumor factors were associated with delays in care. It is reassuring that delays did not influence disease outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70594","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T07:01:16Z","timestamp":1791788476000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delays in breast cancer presentation, diagnosis, and treatment in young women"],"prefix":"10.1002","volume":"132","author":[{"given":"Bessie X.","family":"Zhang","sequence":"first","affiliation":[{"name":"Brigham and Women\u2019s Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2030-9200","authenticated-orcid":false,"given":"Tal","family":"Sella","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Medical Oncology Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"},{"name":"Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zheng","sequence":"additional","affiliation":[{"name":"Data Science Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0386-5223","authenticated-orcid":false,"given":"Gregory J.","family":"Kirkner","sequence":"additional","affiliation":[{"name":"Medical Oncology Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6298-332X","authenticated-orcid":false,"given":"Kathryn J.","family":"Ruddy","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-6385","authenticated-orcid":false,"given":"Shoshana M.","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia F.","family":"Borges","sequence":"additional","affiliation":[{"name":"University of Colorado Cancer Center  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1431-6543","authenticated-orcid":false,"given":"Lidia","family":"Schapira","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology Department of Medicine Stanford University  Stanford California USA"},{"name":"Stanford Cancer Institute  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven E.","family":"Come","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7138-6404","authenticated-orcid":false,"given":"Jeffrey M.","family":"Peppercorn","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Collins","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4722-4824","authenticated-orcid":false,"given":"Ann H.","family":"Partridge","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Medical Oncology Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen D.","family":"Brantley","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Medical Oncology Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27397"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201090053\u20109"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2012.102"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13058\u2010014\u20100427\u20105"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552\u2010025\u201001968\u20107"},{"key":"e_1_2_9_7_1","unstructured":"Cancer Stat Facts: Cancer Among Adolescents and Young Adults (AYAs) (Ages 15\u201339). 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