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The scheduling of elective surgery after SARS\u2010CoV\u20102 infection depends on infection severity, vaccination status, patient factors, and surgical urgency. In the post\u2010vaccination Omicron era of the coronavirus disease 2019 (COVID\u201019) pandemic, there is limited evidence regarding the medium\u2010 and long\u2010term postoperative outcomes and optimal surgical timing for patients with breast cancer recovering from COVID\u201019. This ambidirectional cohort study included 392 patients who underwent breast cancer surgery either more than 2\u2009weeks after or 12\u2009weeks before a COVID\u201019 diagnosis. Patients were stratified according to the time from COVID\u201019 diagnosis to surgery and were followed longitudinally for 1\u2009year to evaluate the evolution of postoperative outcomes. Propensity score matching and stabilized inverse probability of treatment weighting methods were used to mitigate confounding factors, determine the optimal timing of surgery, and assess risk factors. No deaths or severe postoperative complications occurred within 1\u2009year of surgery. Patients with preoperative COVID\u201019 history had a higher risk of medium\u2010term adverse postoperative outcomes than those without (26.2% vs. 10.2%). Multiple analyses revealed that for patients with breast cancer and preoperative COVID\u201019 history, delaying surgery beyond 4 or even 8\u2009weeks after COVID\u201019 diagnosis did not significantly reduce the risk of medium\u2010 or long\u2010term adverse postoperative outcomes (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&gt;\u2009.05). In the post\u2010vaccination Omicron era, our evidence supports timely performing surgery 2\u2009weeks after COVID\u201019 diagnosis in fully vaccinated patients with breast cancer.\n                  <\/jats:p>","DOI":"10.1002\/ijc.35466","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T06:35:17Z","timestamp":1746426917000},"page":"1183-1196","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Timing of surgery and 1\u2010year postoperative outcomes in patients with breast cancer and preoperative\n                    <scp>COVID<\/scp>\n                    \u201019 history: A matched, longitudinal, ambidirectional cohort study"],"prefix":"10.1002","volume":"157","author":[{"given":"Yali","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Breast Surgery Fujian Medical University Union Hospital  Fuzhou Fujian Province China"},{"name":"Department of General 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