{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T23:39:53Z","timestamp":1792625993064,"version":"4.5.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002960","name":"V\u00e4sterbotten L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002960","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer Res Treat"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The interval between breast cancer diagnosis and surgery is psychologically demanding, and meeting the Swedish standardised care pathway target has remained challenging. We examined whether diagnosis-to-surgery lead time is associated with patient-reported psychological outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a longitudinal cohort study using Swedish National Quality Register for Breast Cancer data (2020\u20132024). The cohort comprised 2,906 women with primary invasive breast cancer undergoing surgery, with patient-reported outcome measure (PROM) data at baseline (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092,906), 6 months (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092,638), and 12 months (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092,678). Lead time from biopsy to surgery was modelled continuously (per 1 SD\u2009\u2248\u200919 days). The primary outcome was worry about future health (EORTC QLQ-BR23 item 43); secondary outcomes were general worry, tension, depressed mood, and overall quality of life. Associations were estimated using mixed-effects cumulative link models adjusted for clinical and tumour factors, pandemic era, patient, and healthcare region.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median lead time was 32 days (IQR 23\u201342). Longer lead time was associated with greater worry about future health (adjusted OR 1.15 per SD, 95% CI 1.04\u20131.27), while associations with the secondary outcomes were smaller and not statistically significant. At baseline, high future-health worry was more common with lead times\u2009&gt;\u200935 vs.\u2009\u2264\u200935 days (42.2% vs. 35.1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Longer diagnosis-to-surgery lead time was associated with greater future-health worry, with smaller, non-significant associations for general distress and quality of life. The findings highlight the preoperative waiting period as a potential context for improved communication about expected timelines and reasons for delay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10549-026-08107-z","type":"journal-article","created":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T17:46:46Z","timestamp":1792345606000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis-to-surgery lead time and future-health worry in women with primary breast cancer: a longitudinal Swedish registry-based cohort study"],"prefix":"10.1007","volume":"220","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4653-2067","authenticated-orcid":false,"given":"Johan","family":"Eriksson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7811-9317","authenticated-orcid":false,"given":"Irma","family":"Fredriksson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Lindholm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8171-7227","authenticated-orcid":false,"given":"Micael","family":"Appelblad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7516-9543","authenticated-orcid":false,"given":"Malin","family":"Sund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"key":"8107_CR1","unstructured":"National Board of Health and Welfare (Sweden) (2025) Statistics on Cancer Incidence 2024. 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The study was performed in accordance with the principles of the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Individual patient consent was waived under applicable Swedish law governing registry-based research.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"During the preparation of this work, the authors did not use any AI-assisted technologies.","order":4,"name":"Ethics","label":"Declaration of generative AI and AI-assisted technologies in the manuscript preparation process","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors whose names are listed immediately below report the following details of affiliation or involvement in an organization or entity with a financial or non-financial interest in the subject matter or materials discussed in this manuscript: Irma Fredriksson is the register holder of the Swedish National Quality Register for Breast Cancer (NKBC) and has received institutional research grants from MSD for research projects performed under the Master Collaboration Agreement between MSD and Karolinska Institutet, unrelated to this work.The authors whose names are listed immediately below certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers\u2019 bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript: Johan Eriksson, Lena Lindholm, Micael Appelblad, Malin Sund.","order":5,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"3"}}