Lower-Income Young Women Waited Longer for Breast Cancer Care, and the Delays Were Not Linked to Survival

Lower income was associated with a longer wait before seeing a doctor among women diagnosed with breast cancer at 40 or younger, according to an analysis published Oct. 12, 2026, in the journal Cancer. The delays the study counted were not associated with survival.

Breast cancer in young patients is often found at a later stage, which the authors say can mean a poor prognosis. They set out to establish which patients experience delays in care and whether those delays affect outcomes.

The analysis covers 1,071 women enrolled in the Young Women's Breast Cancer Study between 2006 and 2016. It counted 153 presentation delays, meaning a wait of 90 days or more between a first symptom and a visit to a provider. There were 120 diagnostic delays, 90 days or more from that visit to a diagnosis, and 228 treatment delays, 60 days or more from diagnosis to the start of treatment.

Bessie X. Zhang, of Brigham and Women's Hospital in Boston, and colleagues report that lower annual income was associated with higher odds of a presentation delay. Pregnancy at diagnosis and a family history of breast cancer were associated with lower odds, as were triple-negative tumors, an aggressive subtype. Younger patients had higher odds of a diagnostic delay, and women with more aggressive tumor subtypes were less likely to have a treatment delay. These are associations found in a cohort that already existed, not the result of a trial.

The authors report that none of the three delays was associated with overall survival, or with disease-free survival, the time a patient stays free of returning cancer. They describe that as reassuring.

Among tumors classified as HER2-positive luminal B, presentation delays were associated with a later stage at diagnosis.