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Review
. 2023 Dec 11;28(12):e1179-e1184.
doi: 10.1093/oncolo/oyad255.

The Impact of COVID-19 on Treatment Practices for Patients With Early Breast Cancer: A Cross-Sectional Study From a Large Cancer Center in Italy

Fabio Girardi  1 , Sabrina Marini  1   2 , Francesca Porra  1   2 , Sonia Carpentieri  3 , Alberto Marchet  3 , Tania Saibene  3 , Marcello Lo Mele  4 , Tommaso Giarratano  1 , Carlo Alberto Giorgi  1 , Eleonora Mioranza  1 , Cristina Falci  1 , Giovanni Faggioni  1 , Francesca Caumo  5 , Gaia Griguolo  1   2 , Maria Vittoria Dieci  1   2 , Valentina Guarneri  1   2
Affiliations
Review

The Impact of COVID-19 on Treatment Practices for Patients With Early Breast Cancer: A Cross-Sectional Study From a Large Cancer Center in Italy

Fabio Girardi et al. Oncologist. .

Abstract

Introduction: The Coronavirus Disease 2019 (COVID-19) has disrupted health services worldwide. The evidence on the impact of the pandemic on cancer care provision, however, is conflicting. We aimed to audit the management of patients diagnosed with early breast cancer (EBC) during the pandemic in a large, tertiary-level cancer center in Italy.

Methods: We conducted a cross-sectional study to track the route to first treatment for patients diagnosed with EBC during 2019, 2020, and 2021. We abstracted data for all consecutive patients referred to the Veneto Institute of Oncology (Padua, Italy). We defined as point of contact (POC) the date of the first consultation with a breast cancer specialist of the breast unit. First treatment was defined as either upfront surgery or neoadjuvant chemotherapy (NACT).

Results: We reviewed medical records for 878 patients for whom an MDT report during 2019-2021 (April through June) was available. Of these, 431 (49%) were eligible. The proportion of screen-detected tumors was larger in 2019 and 2021 than in 2020 (59%). Conversely, the proportion of screen-detected tumors was offset by the proportion of palpable tumors in 2020 (P = .004). Distribution of tumor and nodal stage was unchanged over time, but in situ tumors were slightly fewer in 2020 than in 2019 or 2021. The adjusted odds ratio for treatment delay (45 days or more) was 0.87 for 2020 versus 2019 (95% CI, 0.5-1.53) and 0.9 for 2021 versus 2019 (95% CI, 0.52-1.55).

Conclusions: There was no evidence for major changes in the management of patients with EBC during 2019-2021 and no treatment delays were observed. Our findings suggest that more women presented with palpable nodules at diagnosis, but the stage distribution did not change over time. Validation on a larger cohort of patients is warranted to robustly assess the impact of the COVID-19 pandemic on treatment practices for patients with EBC.

Keywords: COVID-19; breast cancer; cancer care; treatment delay.

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Conflict of interest statement

Fabio Girardi reported personal fees as invited speaker from AstraZeneca and Lilly. Eleonora Mioranza: Eli Lilly, Istituto Gentili, Novartis. Cristina Falci: Amgen, Eli Lilly, Novartis. Gaia Griguolo reported personal fees as invited speaker from Eli Lilly and Novartis and advisory boards for Gilead and Seagen. Maria Vittoria Dieci reported personal fees for advisory/consultancy role from AstraZeneca, Bristol Myers Squibb, Daiichi Sankyo, Eli Lilly, Exact Sciences, Gilead, MSD, Novartis, Pfizer, Seagen, Roche. Valentina Guarneri reported advisory role for Eli Lilly, Novartis, MSD, AstraZeneca, EISAI, PierreFabre, Olema Oncology, Merck Serono, and Gilead; Speaker’s Bureau for Gilead, GSK, Amgen, Novaris, Roche, EliLilly, Daiichi Sankyo, Exact Sciences, and AstraZeneca; and expert testimony for Eli Lilly. The other authors indicated no financial relationships.

Figures

Figure 1.
Figure 1.
Distribution by symptoms at presentation.
Figure 2.
Figure 2.
Distribution by tumor stage.
Figure 3.
Figure 3.
Distribution by nodal stage.
See this image and copyright information in PMC

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