•        Introduction: Randomized clinical trials have shown a survival benefit associated with the use of adjuvant chemotherapy in early-stage breast cancer. Time to chemotherapy influenced survival outcomes with stage III breast cancer, Triple negative breast cancer and trastuzumab-treated HER2-positive tumours who experienced worse outcomes when chemotherapy was delayed. Re-excisions after breast-conserving surgery (BCS) for breast cancer also cause delays in the adjuvant treatment.

•        Aim/Method: This study's aim was to analyse time in management pathways of early breast cancer and to identify 1) time from diagnosis of early breast cancer to surgery; 2) Rates of re-excision and median time from surgery to initiation of adjuvant chemotherapy.  Early breast cancer patients treated with adjuvant chemotherapy treated at Princess Alexandra Hospital were retrospective analysed over a 36 month period from 2012 to 2014.

•        Results: Total 309 patients were included in study. Median age of patients was 54 years. Majority of patients (72%)   had node positive disease , T2/3 ( 68%)  disease and 21% patients had triple negative disease. 253 ( 82%) patients had breast conservation surgery  and 80 ( 26%) had mastectomy. Total 42 (16 %) patients had re-excision surgery and majority of patients 32 (76%) had re-excision for Positive margins. 3 Patients had second re-excision due to involved margins. Median time from diagnosis to surgery, surgery to commencement of adjuvant chemotherapy was 27 and 25 days respectively.  Chemotherapy was delayed in patients requiring re-excision, median time to commence chemotherapy in this group was 47 days.

•        Conclusion: Rates of re-excision in patients with early breast cancer at our centre is low compared to previous published reports. Majority of patients started adjuvant chemotherapy within 4 weeks post-surgery however patients requiring re-excision surgery resulted in delaying of adjuvant chemotherapy.