Effect of the COVID-19 Pandemic on Surgical Breast Cancer Care in the Netherlands: A Multicenter Retrospective Cohort Study

Filipe, Mando D.; Deukeren, Désirée van; Kip, Marijn; Doeksen, A.; Pronk, Apollo; Verheijen, Paul M.; Heikens, Joost T.; Witkamp, Arjen J.; Richir, Milan C.

doi:10.1016/j.clbc.2020.08.002

Cited by 51 publications

(77 citation statements)

References 25 publications

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“…No statistically significant changes were observed in the overall scores of the Breast-Q, SF-36 and EQ-5D-5L questionnaires at baseline compared to 2 weeks, 3 and 6 months after ductoscopy, indicating that ductoscopy does not negatively influence QOL. These findings further support the use of ductoscopy, which is performed more and more for both diagnostic and therapeutic purposes [ 26 , 34 , 35 ]. Additionally, this study showed that the all domains of Breast-Q, and EQ-5D-5L were stable over time and are thereby useful questionnaires for PND patients, while SF-36 was as a whole less useful and would require modifications.…”

Section: Discussionsupporting

confidence: 61%

“…A meta-analysis showed that ductoscopy has a sensitivity of 94% in detecting intraductal lesions of any type, but cannot reliably discriminate between benign and malignant lesions [ 46 ]. Another network meta-analysis showed that ductoscopy has a significantly higher diagnostic accuracy than MRI for the detection of malignancy in patients with PND and negative ultrasound and/or mammography [ 47 ]. Therefore, ductoscopy is more useful when conventional imaging is negative [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another network meta-analysis showed that ductoscopy has a significantly higher diagnostic accuracy than MRI for the detection of malignancy in patients with PND and negative ultrasound and/or mammography [ 47 ]. Therefore, ductoscopy is more useful when conventional imaging is negative [ 26 ]. New techniques in ductoscopy are currently being developed and explored to improve the sensitivity for the detection of (pre)malignant lesions.…”

Section: Discussionmentioning

confidence: 99%

“…This prospective consecutive study included women who presented with unilateral PND between 2014 and 2015 in the University Medical Centre Utrecht (UMCU) in The Netherlands. Part of these patients were reported before [ 26 ]. Inclusion criterion was patients with PND lasting more than at least 3 months.…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies showed the success of ductoscopy in finding the intraductal lesion causing PND before or during duct excision [ 19 – 23 ]. Moreover, it is possible to remove or laser-destruct intraductal lesions causing PND, thereby preventing surgery [ 18 , 24 – 26 ], and new approaches such as auto-fluorescence ductoscopy may improve the detection of precancerous lesions in patients with high risk of developing cancer [ 27 – 29 ]. Despite the increasing relevance of ductoscopy for diagnostic and therapeutic purposes, there are no data available on the impact on the quality of life after ductoscopy.…”

Section: Introductionmentioning

confidence: 99%

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Patient-reported outcomes of ductoscopy procedures for pathologic nipple discharge

et al. 2020

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Background Pathologic nipple discharge (PND) is a common complaint often associated with breast cancer. However, when ultrasound and mammography are negative, the chances of malignancy are lower than 5%. Currently, major duct excision and microdochectomy are often recommended to alleviate symptoms and definitely rule out malignancy, but can cause infections and breastfeeding problems. Ductoscopy is a minimally invasive endoscopy technique that allows visualization of the mammary ducts and may not only obviate surgery but also detect malignancy. The aim of this study was to determine quality of life (QOL) after ductoscopy in patients with PND. Materials and methods All PND patients referred for ductoscopy between 2014 and 2015 to our hospital were included. Ductoscopy procedures were performed under local anaesthesia in the outpatient clinic. Patients were asked to fill out questionnaires (Breast-Q, EQ-5D-5L and SF-36) on the day of ductoscopy, and after 2 weeks, 3 and 6 months. Additionally, we performed reliability analysis to determine if these questionnaires were suitable for PND patients. Results Fifty consecutive patients underwent ductoscopy of whom 47 patients participated in this study. One domain of SF-36 (vitality) varied significantly over time. Breast-Q, SF-36 and EQ-5D-5L showed that QOL after ductoscopy for PND was unaffected by ductoscopy. Success of the ductoscopy procedure was a significant predictor for satisfaction with the result domain. Conclusion Ductoscopy is a minimally invasive technique that does not seem to impact QoL of PND patients over time. Breast-Q, SF-36 and EQ-5D-5L seem to be suitable existing QOL tests for PND patients undergoing ductoscopy, whereas SF-36 would require modifications.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient-reported outcomes of ductoscopy procedures for pathologic nipple discharge

et al. 2020

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Impact of the COVID‐19 pandemic on the in‐hospital diagnostic pathway of breast and colorectal cancer in the Netherlands: A population‐based study

Wolfkamp,

Meijer,

van Hoeve

et al. 2024

Cancer Medicine

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BackgroundIn the Netherlands, the COVID‐19 pandemic resulted in a temporary halt of population screening for cancer and limited hospital capacity for non‐COVID care. We aimed to investigate the impact of the pandemic on the in‐hospital diagnostic pathway of breast cancer (BC) and colorectal cancer (CRC).Methods71,159 BC and 48,900 CRC patients were selected from the Netherlands Cancer Registry. Patients, diagnosed between January 2020 and July 2021, were divided into six periods and compared to the average of patients diagnosed in the same periods in 2017–2019. Diagnostic procedures performed were analysed using logistic regression. Lead time of the diagnostic pathway was analysed using Cox regression. Analyses were stratified for cancer type and corrected for age, sex (only CRC), stage and region.ResultsFor BC, less mammograms were performed during the first recovery period in 2020. More PET‐CTs were performed during the first peak, first recovery and third peak period. For CRC, less ultrasounds and more CT scans and MRIs were performed during the first peak. Lead time decreased the most during the first peak by 2 days (BC) and 8 days (CRC). Significantly fewer patients, mainly in lower stages, were diagnosed with BC (−47%) and CRC (−36%) during the first peak.ConclusionSignificant impact of the COVID‐19 pandemic was found on the diagnostic pathway, mainly during the first peak. In 2021, care returned to the same standards as before the pandemic. Long‐term effects on patient outcomes are not known yet and will be the subject of future research.

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Impact of the COVID‐19 pandemic on diagnosis of new cancers: A national multicenter study of the Veterans Affairs Healthcare System

Englum

Prasad

Lake

et al. 2021

Cancer

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Background The coronavirus disease 2019 (COVID‐19) pandemic caused disruptions in treatment for cancer. Less is known about its impact on new cancer diagnoses, where delays could cause worsening long‐term outcomes. This study quantifies decreases in encounters related to prostate, lung, bladder and colorectal cancers, procedures that facilitate their diagnosis, and new diagnoses of those cancers in the COVID era compared to pre‐COVID era. Methods All encounters at Veterans' Affairs facilities nationwide from 2016 through 2020 were reviewed. The authors quantified trends in new diagnoses of cancer and in procedures facilitating their diagnosis, from January 1, 2018 onward. Using 2018 to 2019 as baseline, reductions in procedures and new cancer diagnoses in 2020 were estimated. Calculated absolute and percentage differences in annual volume and observed‐to‐expected volume ratios were calculated. Heat maps and funnel plots of volume changes were generated. Results From 2018 through 2020, there were 4.1 million cancer‐related encounters, 3.9 million relevant procedures, and 251,647 new cancers diagnosed. Compared to the annual averages in 2018 through 2019, colonoscopies in 2020 decreased by 45% whereas prostate biopsies, chest computed tomography scans, and cystoscopies decreased by 29%, 10%, and 21%, respectively. New cancer diagnoses decreased by 13% to 23%. These drops varied by state and continued to accumulate despite reductions in pandemic‐related restrictions. Conclusion The authors identified substantial reductions in procedures used to diagnose cancer and subsequent reductions in new diagnoses of cancer across the United States because of the COVID‐19 pandemic. A nomogram is provided to identify and resolve these unmet health care needs and avoid worse long‐term cancer outcomes. Lay Summary The disruptions due to the COVID‐19 pandemic have led to substantial reductions in new cancers being diagnosed. This study quantifies those reductions in a national health care system and offers a method for understanding the backlog of cases and the resources needed to resolve them.

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Effect of the COVID-19 Pandemic on Surgical Breast Cancer Care in the Netherlands: A Multicenter Retrospective Cohort Study

Cited by 51 publications

References 25 publications

Patient-reported outcomes of ductoscopy procedures for pathologic nipple discharge

Patient-reported outcomes of ductoscopy procedures for pathologic nipple discharge

Impact of the COVID‐19 pandemic on the in‐hospital diagnostic pathway of breast and colorectal cancer in the Netherlands: A population‐based study

Impact of the COVID‐19 pandemic on diagnosis of new cancers: A national multicenter study of the Veterans Affairs Healthcare System

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