A tripartite approach can seek to optimize breast cancer management during a pandemic – Real‐Time experience of a developing breast oncology unit in Singapore

Ngaserin, Sabrina; Chua, Hui Wen; Chew, Min Hoe; Tan, Benita Kiat Tee

doi:10.1111/tbj.13961

Cited by 3 publications

(15 citation statements)

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“…The initial search identified 485 abstracts. After screening, 15 full-text studies met our eligibility criteria [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] (Figure 1: PRISMA flowchart). These studies reported outcomes for 6,353 people treated for early breast cancer from January 2020 to June 2021.…”

Section: Resultsmentioning

confidence: 99%

“…There were eight studies from Europe, 10,[12][13][14]19,21,23,24 five from North America, 11,[15][16][17]22 and two from Asia. 18,20 Eleven studies compared treatment during the COVID period to a similar non-COVID period. 10,11,[13][14][15]17,[19][20][21]23,24 There were four, 12,16,18,21 prospective and 11 retrospective studies.…”

Section: Resultsmentioning

confidence: 99%

“…18,20 Eleven studies compared treatment during the COVID period to a similar non-COVID period. 10,11,[13][14][15]17,[19][20][21]23,24 There were four, 12,16,18,21 prospective and 11 retrospective studies. 10,11,[13][14][15]17,19,20,[22][23][24] Four compared the actual treatment of individual patients during the COVID to the 'usual' or 'ideal' treatment that would usually have been delivered in a non-COVID period.…”

Section: Resultsmentioning

confidence: 99%

“…10,11,[13][14][15]17,[19][20][21]23,24 There were four, 12,16,18,21 prospective and 11 retrospective studies. 10,11,[13][14][15]17,19,20,[22][23][24] Four compared the actual treatment of individual patients during the COVID to the 'usual' or 'ideal' treatment that would usually have been delivered in a non-COVID period. 12,16,18,22 For treatment modalities, 14 studies included data for surgery [10][11][12][13][14][15][16][18][19][20][21][22][23][24] , ten for neoadjuvant chemotherapy, 10,[12][13][14][15]…”

Section: Resultsmentioning

confidence: 99%

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The Impact of COVID-19 on Breast Cancer Treatment: A Systematic Review

Budiarta

Brennan

2022

Arch Breast Cancer

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Background: During the COVID-19 pandemic, health resources were stretched, access was impacted by lockdowns and there were concerns about exposure to the virus during visits to hospitals. The purpose of this study was to examine how breast cancer treatments (presentation, surgery, radiotherapy, chemotherapy and/or endocrine therapy) changed or were adapted during the early phase of the pandemic. Methods: A systematic review was conducted using PRISMA guidance. Eligible studies presented original data reporting changes to early breast cancer treatment by comparing ‘pandemic’ treatment to a ‘pre-pandemic’ cohort or to ‘ideal’ treatment of individual cases. Data were extracted into evidence tables and narrative synthesis was used to analyse results. Results: Fifteen studies with paired design were eligible. These reported outcomes for 6,353 people treated for early breast cancer (January 2020–June 2021). All studies reported some change to treatment due to the pandemic. The nature of reported changes was inconsistent. Changes included: tumours more advanced at presentation compared to pre-pandemic, increase in breast conserving surgery; increase in simple mastectomy (without breast reconstruction); trend towards increased wait times, delays to start of treatment, shorter post-operative hospital stay and hypofractionation or omission of radiotherapy. Centres used more or less neoadjuvant chemotherapy or endocrine therapy. Conclusion: In the early stage of the pandemic, fewer early-stage breast cancer cases were treated many centres. Treatment for breast cancer was impacted and various local solutions were developed. These included less complicated breast surgery, increased use of neoadjuvant therapy, and changes to radiotherapy regimens. Surgery was frequently delayed and breast reconstruction was often unavailable. These results have implications for breast cancer services during the pandemic recovery as a ‘catch-up’ increase in cancer diagnoses is expected. Women may wish to access breast reconstruction, unavailable due to COVID-19. The impact of changes to treatment on long-term quality of life should be evaluated.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Impact of COVID-19 on Breast Cancer Treatment: A Systematic Review

Budiarta

Brennan

2022

Arch Breast Cancer

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“…The biggest contributors in this category were from surgical specialties , with general surgery [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] being the most active in producing articles. The internal medicine departments were led by cardiology [86][87][88][89][90][91][92][93] and oncology [113][114][115][116][117][118][119][120]. There were some contributions by allied health and dentistry departments [121][122][123][124], with an article on nursing [123] and occupational therapy [124].…”

Section: Figurementioning

confidence: 99%

One Year on: An Overview of Singapore’s Response to COVID-19—What We Did, How We Fared, How We Can Move Forward

Anand

Shuy

Lee³

et al. 2021

IJERPH

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Background—One year has passed since the first COVID-19 case in Singapore. This scoping review commemorates Singaporean researchers that have expanded the knowledge on this novel virus. We aim to provide an overview of healthcare-related articles published in peer-reviewed journals, authored by the Singapore research community about COVID-19 during the first year of the pandemic. Methods—This was reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. It included healthcare-related articles about COVID-19 published between 23 January 2020 and 22 January 2021 with a Singapore-affiliated author. MEDLINE, Embase, Scopus, Web of Science, CINAHL, PsycINFO, Google Scholar, and local journals were searched. The articles were screened independently by two reviewers. Results—The review included 504 articles. Most of the articles narrated the changes to hospital practice (210), while articles on COVID-19 pathology (94) formed most of the non-narrative papers. Publications on public health (61) and the indirect impacts to clinical outcomes (45) were other major themes explored by the research community. The remaining articles detailed the psychological impact of the pandemic (35), adaptations of medical education (30), and narratives of events (14). Conclusion—Amidst a resurgence of community cases involving variant COVID-19 strains, the resources from the research community will provide valuable guidance to navigate these uncertain times.

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Has the COVID‐19 pandemic resulted in more advanced breast cancer? A hospital‐based retrospective study

Howdle,

Stephanou,

Barrett

et al. 2024

ANZ Journal of Surgery

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BackgroundThe suspension of breast cancer screening during the COVID‐19 pandemic altered patient diagnosis and management. This study investigates the impact of the COVID‐19 lockdowns, screening delays and reduced healthcare attendance on changes in tumour and treatment characteristics, particularly for biologically more aggressive breast cancers.MethodsThis retrospective single‐hospital analysis utilized data from a prospective cancer database between July 2019 and June 2022. Patient, tumour and treatment factors were compared across pre‐pandemic, pandemic and post‐pandemic groups.ResultsSymptomatic breast cancer increased from 42.3% in the pre‐, 53.1% in the pandemic and 57% in the post‐ respectively (P ≤ 0.05). Compared to the pre‐pandemic group (4.6%), an increase in stages 3 or 4 breast cancers in the pandemic (8.5%) and post‐pandemic (7.1%) was found. Increased node‐positivity in Ki67 > 20%, grade 3 or ER‐ tumours post‐pandemic (+5.4%, +14.8%, +33.4%, respectively) was identified. More neoadjuvant chemotherapy was found in both the pandemic (+4.3%) and post‐pandemic (+11.3%, P = 0.0261) groups. An increase in hypofractionated radiotherapy in the post‐pandemic group (+9.4%) was also identified.ConclusionOur study identified a decrease in early‐stage cancers and an increase in node positivity, particularly for biologically more aggressive tumours. An increase in the number of patients receiving neoadjuvant chemotherapy or hypofractionated radiotherapy during the pandemic and post‐pandemic periods was also identified.

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A tripartite approach can seek to optimize breast cancer management during a pandemic – Real‐Time experience of a developing breast oncology unit in Singapore

Cited by 3 publications

References 4 publications

The Impact of COVID-19 on Breast Cancer Treatment: A Systematic Review

The Impact of COVID-19 on Breast Cancer Treatment: A Systematic Review

One Year on: An Overview of Singapore’s Response to COVID-19—What We Did, How We Fared, How We Can Move Forward

Has the COVID‐19 pandemic resulted in more advanced breast cancer? A hospital‐based retrospective study

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