CoC National Cancer Database announces a new breast quality measure that establishes “time to therapeutic breast surgery <60 days”

The Commission on Cancer (CoC) National Cancer Database announces a new breast quality measure that establishes “time to therapeutic breast surgery <60 days” as a surveillance measure for 1,500+ CoC-accredited sites—exactly what the XpediteMD is designed to address.

The CoC’s decision to require “time to therapeutic breast surgery” within 60 days of diagnosis was driven almost entirely by high-quality evidence showing that every incremental delay in definitive treatment translates into worse survival outcomes. In particular:

• Demonstrated impact on survival
  A landmark analysis of over 200 000 Stage I–III breast cancer patients in both SEER-Medicare and the NCDB cohorts found that each 60-day increase in the interval from diagnosis to surgery was associated with a statistically significant rise in both overall mortality (HR ~1.10 per interval) and breast cancer–specific mortality (subhazard ratio ~1.26) pmc.ncbi.nlm.nih.gov.
• Rising preoperative intervals
  Although the median time to surgery in Medicare patients increased from about 21 days in 1992 to 32 days by 2005, there was no evidence that these longer intervals conferred any clinical benefit—only harm. This trend underscored the need for a firm benchmark to drive quality improvement pmc.ncbi.nlm.nih.gov.
• Quality-of-care standardization
  By codifying 60 days as the upper limit for non-neoadjuvant, therapeutic surgery, the CoC created a clear, measurable quality metric. CoC-accredited programs now report these intervals to the NCDB, allowing benchmarking, identification of system-level bottlenecks, and targeted interventions to streamline the preoperative pathway.
• Alignment with CoC mission
  The Commission on Cancer’s charter is to improve both survival and quality of life; setting an evidence-based time-to-treatment standard directly advances that mission by incentivizing timely access to potentially curative surgery.

In short, the “< 60 days” rule was adopted to translate robust epidemiologic data into a national quality measure—one that holds cancer programs accountable for minimizing avoidable delays and thus maximizing patient outcomes.

These standards are now monitored by CoC-accredited hospitals via the National Cancer Database (NCDB) to improve timely access to potentially lifesaving surgery.

For breast cancer, the NCDB Quality Measures focus on timely surgical and systemic care: 

• BCSdx (launched 2022) requires that patients with clinical stage I–III breast cancer receive their first therapeutic surgery within 60 days of diagnosis 

• BneoCT (implemented 2024) mandates that patients aged 75 or younger with HER2‑positive or triple‑negative disease and any nodal/dimensions criteria begin neoadjuvant chemotherapy or immunotherapy within 60 days of diagnosis