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. 2021 Dec;24(6):491-503.
doi: 10.4048/jbc.2021.24.e55.

Impact of the COVID-19 Pandemic on the Diagnosis and Surgery of Breast Cancer: A Multi-Institutional Study

Young-Joon Kang  1 , Jong Min Baek  2 , Yong-Seok Kim  3 , Ye Won Jeon  4 , Tae-Kyung Yoo  5 , Jiyoung Rhu  6 , Chang-Hyun Shin  1 , Shijin Cho  1 , Hoon Choi  1 , Se Jeong Oh  7
Affiliations

Impact of the COVID-19 Pandemic on the Diagnosis and Surgery of Breast Cancer: A Multi-Institutional Study

Young-Joon Kang et al. J Breast Cancer. 2021 Dec.

Abstract

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the rates of screening, case identification, and referral for cancer diagnosis. We investigated the diagnosis and surgery status of breast cancer before and after the COVID-19 pandemic at a multi-institutional level.

Methods: We collected breast cancer data from the clinical data warehouse which contained the medical records of patients from six academic institutions in South Korea. Patients were divided into two groups: February to April (period A) and May to July (period B). The data from the two groups were then compared against the same periods in 2019 and 2020. The primary objective was to investigate the differences in breast cancer stages before and after the COVID-19 pandemic.

Results: Among 3,038 patients, there was a 9.9% reduction in the number of diagnoses in 2020. This decrease was more significant during period A than period B. The breast cancer stage was not statistically different in period A (p = 0.115), but it was in period B (p = 0.001). In the subset analysis according to age, there was a statistical difference between 2019 and 2020 in period B for patients under the age of 65 years (p = 0.002), but no difference was observed in the other groups.

Conclusion: The number of breast cancer cases declined during the pandemic, and the staging distribution has changed after the pandemic peak.

Keywords: Breast Neoplasms; COVID-19; Carcinoma; Early Detection of Cancer; SARS-CoV-2.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Timeline of the COVID-19 pandemic in South Korea and the number of breast cancer diagnoses.
COVID-19 = coronavirus disease 2019.
Figure 2
Figure 2. Numbers of newly diagnosed breast cancer patients before and after the COVID-19 pandemic at six university hospitals.
(A) During periods A (February to April) and B (May to July). (B) According to age during period A. (C) According to age during period B. COVID-19 = coronavirus disease 2019.
Figure 3
Figure 3. Numbers of breast imaging modalities (mammogram and breast sonography).
(A) Numbers of breast cancer screening (asymptomatic group). (B) Numbers of primary breast imaging modalities (asymptomatic and diagnostic groups). (C) Numbers of breast cancer screenings according to age during period A (February to April). (D) Numbers of breast cancer screenings according to age during period B (May to July).
Figure 4
Figure 4. Numbers of breast cancer surgeries.
(A) Breast surgeries during period A (February to April). (B) Breast surgeries during period B (May to July). (C) Numbers of axillary surgeries. (D) Numbers of reconstruction surgeries. SLNB = sentinel lymph node biopsy; ALND = axillary lymph node dissection.
Figure 5
Figure 5. Clinical stage distribution of breast cancer.
(A) During period A (February to April). (B) During period B (May to July).
Figure 6
Figure 6. Clinical stage distribution of breast cancer according to age.
(A) Patients younger than 65 years in period A (February to April). (B) Patients younger than 65 years in period B (May to July). (C) Patients older than 65 years in period A. (D) Patients older than 65 years in period B.
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