Longer time to surgery (TTS) isassociated with worse survival in patients with breast cancer. Whether this associationhas encouraged more prompt care delivery remains unknown. The National Cancer Database was used to identify patients ≥18 years of agediagnosed with clinical stage 0-III breast cancer between 2006 and 2019 for whom surgery was the first mode of treatment.A linear-by-linear test fortrend assessed median TTS acrossthe interval. Adjusted linear regression modelingwas used to examineTTS trends across patient subgroups. Overall, 1,435,584 patients met the inclusion criteria. The median age was 63 years (interquartile range [IQR] 53-72), 84.3% of patients were White, 91.1% were non-Hispanic, and 99.2% were female. The median TTS in 2006 was 26 days (IQR 16-39) versus39 days in 2019(IQR 27-56)[p<0.001]. In a multivariable linear regression model, TTS increased significantly, with an annualincrease of 0.83 days(95% confidence interval 0.82-0.85; p<0.001).A consistent, significant increase in TTS was observed on subgroup analyses by surgery type, reconstruction, patient race, hospital type, and disease stage. Black race, Hispanic ethnicity, and having either Medicaid or being uninsured were significantly associated with prolonged TTS, as were mastectomy and reconstructive surgery. Despiteevidence that longer TTS is associated with poorer outcomes in patients with breast cancer, TTS has steadily increased, which may be particularly detrimental to marginalized patients. Further studies are needed to ensure the delivery of timely care to all patients.