Background <p>Evidence-based benchmarks have been established to assess the quality of breast cancer care, as delays in treatment correlate with poor clinical outcomes. Our aim was to identify factors influencing the timeliness of care within a rural East Texas healthcare system.</p> Patients and Methods <p>Patients diagnosed with invasive breast cancer were identified and monitored from January 2015 to October 2022. Timeliness of care was assessed retrospectively across three intervals: diagnostic imaging to biopsy, biopsy to surgical treatment, and mammogram to surgical treatment. We analyzed correlations between demographic and clinical factors influencing timely initiation of treatment in our population against recommendations from the National Consortium of Breast Centers (NCBC).</p> Results <p>A total of 278 cases were included over the 5-year study period. Nearly half met the recommended timeline from diagnostic imaging to biopsy, 13.3% from mammogram to surgical treatment, and 10.3% from biopsy to surgical treatment. A delay in the “diagnostic imaging to biopsy” interval or “biopsy to surgical treatment” interval predicted delays in the mammogram to treatment interval. Hispanics were more likely to present with stage 3 cancer and had a 4.5 times higher likelihood of mortality compared with Non-Hispanic whites.</p> Conclusions <p>Delay in one phase of care predicted delays in subsequent phases. Timeliness of treatment also influenced survival rates among Hispanic patients. Understanding factors influencing the timeliness of breast cancer treatment may guide targeted interventions in the future for patients at greater risk of care delays.</p>