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. 2022 Apr;29(4):2231-2239.
doi: 10.1245/s10434-021-11088-6. Epub 2021 Nov 23.

Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis, Presentation, and Patient Management

Jennifer E Tonneson  1 , Tanya L Hoskin  2 , Courtney N Day  2 , Diane M Durgan  1 , Christina A Dilaveri  3 , Judy C Boughey  4
Affiliations

Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis, Presentation, and Patient Management

Jennifer E Tonneson et al. Ann Surg Oncol. 2022 Apr.

Abstract

Introduction: The COVID-19 pandemic caused delays in breast cancer management forcing clinicians to potentially alter treatment recommendations. This study compared breast cancer stage at diagnosis and rates of neoadjuvant therapy among women presenting to our institution before and during COVID-19.

Methods: Retrospective chart review of patients with a new breast cancer diagnosis from March 2020-August 2020 (during-COVID-19) were compared with March 2019-August 2019 (pre-COVID-19). We compared stage at diagnosis, clinical/demographic features, and neoadjuvant therapy use between the time periods.

Results: A total of 573 patients included: 376 pre-COVID-19, 197 during-COVID-19. Method of cancer detection was by imaging in 66% versus 63% and by physical findings/symptoms in 34% versus 37% of patients comparing pre-COVID-19 to during-COVID-19, p = 0.47. Overall clinical prognostic stage did not differ significantly (p = 0.39) between the time periods, nor did cM1 disease (2% in each period); 23% pre-COVID-19 and 27% during-COVID-19 presented with cN+ disease (p = 0.38). Neoadjuvant therapy use was significantly higher during-COVID-19 (39%) versus pre-COVID-19 (29%, p = 0.02) driven by increased neoadjuvant endocrine therapy (NET) use (7% to 16%, p = 0.002), whereas neoadjuvant chemotherapy use did not change (22% vs. 23%, p = 0.72). In HR+/HER2- disease, NET use increased from 10% pre-COVID-19 to 23% during-COVID-19 (p = 0.001) with a significant increase in stage I patients (7 to 22%, p < 0.001) and nonsignificant increases in stage II (18 to 23%, p = 0.63) and stage III (9 to 29%, p = 0.29).

Conclusions: Breast cancer stage at diagnosis did not differ significantly during-COVID-19 compared with pre-COVID-19. More patients during-COVID-19 were treated with NET, which was significantly increased in stage I HR+/HER2- disease.

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Figures

Fig. 1
Fig. 1
Percent of HR+/HER2- patients undergoing NET by AJCC 8th edition clinical prognotic stage
Fig. 2
Fig. 2
Percent of HR+/HER2- patients undergoing NET by BCS pre-COVID and during-COVID
See this image and copyright information in PMC

References

    1. Vanni G, Pellicciaro M, Materazzo M, et al. Lockdown of breast cancer screening for COVID-19: possible scenario. In Vivo. 2020;34(5):3047–3053. doi: 10.21873/invivo.12139. - DOI - PMC - PubMed
    1. Maringe C, Spicer J, Morris M, et al. The impact of the COVID0-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol. 2020;21(8):1023–1034. doi: 10.1016/S1470-2045(20)30388-0. - DOI - PMC - PubMed
    1. COVID-19 Pandemic Breast Cancer Consortium 2020, COVID-19 Guidelines for Triage of Breast Cancer Patients, American College of Surgeons. Available at. https://www.facs.org/covid-19/clinical-guidance/elective-case/breast-cancer. Accessed 17 Sept 2020.
    1. Society of Surgical Oncology. Resource for Management Options of Breast Cancer During COVID-10. https://www.surgonc.org/wp-content/uploads/2020/03/Breast-Resource-durin.... Accessed 19 March 2021.
    1. Dietz JR, Moran MS, Isakoff SJ, et al. Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. The COVID-19 pandemic breast cancer consortium. Breast Cancer Res Treat. 2020;181(3):487–497. doi: 10.1007/s10549-020-05644-z. - DOI - PMC - PubMed

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