Impact of Covid-19 on breast cancer stage at discovery, and time to treatment in Cote d’Or, France

Agbo, C. Feron; Assogba, Emerline L F; Bertaut, Aurélie; Kamga, Ariane Mamguem; Coutant, Charles; Desmoulins, Isabelle; Dancourt, Vincent; Yonli, Tienhan Sandrine Dabakuyo

doi:10.1016/j.pmedr.2023.102248

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…In Burgundy, the authors reported no impact on BC initial presentation or times to anticancer treatment in 2020 compared to 2019. 20 In South West France, investigators reported less new BC cases, diagnosed with larger tumors. 21 In Paris region, a comprehensive cancer center reported no impact of the pandemic on clinical presentation or time to treatment, despite a 42% decrease in the number of initial visits for recently diagnosed BC during the first national lockdown (March–May 2020).…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID‐19 pandemic on clinical presentation, treatments, and outcomes of new breast cancer patients: A retrospective multicenter cohort study

Guével,

Priou,

Lamé

et al. 2023

Cancer Medicine

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BackgroundThe SARS CoV‐2 pandemic disrupted healthcare systems. We compared the cancer stage for new breast cancers (BCs) before and during the pandemic.MethodsWe performed a retrospective multicenter cohort study on the data warehouse of Greater Paris University Hospitals (AP‐HP). We identified all female patients newly referred with a BC in 2019 and 2020. We assessed the timeline of their care trajectories, initial tumor stage, and treatment received: BC resection, exclusive systemic therapy, exclusive radiation therapy, or exclusive best supportive care (BSC). We calculated patients' 1‐year overall survival (OS) and compared indicators in 2019 and 2020.ResultsIn 2019 and 2020, 2055 and 1988, new BC patients underwent cancer treatment, and during the two lockdowns, the BC diagnoses varied by −18% and by +23% compared to 2019. De novo metastatic tumors (15% and 15%, p = 0.95), pTNM and ypTNM distributions of 1332 cases with upfront resection and of 296 cases with neoadjuvant therapy did not differ (p = 0.37, p = 0.3). The median times from first multidisciplinary meeting and from diagnosis to treatment of 19 days (interquartile 11–39 days) and 35 days (interquartile 22–65 days) did not differ. Access to plastic surgery (15% and 17%, p = 0.08) and to treatment categories did not vary: tumor resection (73% and 72%), exclusive systemic therapy (13% and 14%), exclusive radiation therapy (9% and 9%), exclusive BSC (5% and 5%) (p = 0.8). Among resected patients, the neoadjuvant therapy rate was lower in 2019 (16%) versus 2020 (20%) (p = 0.02). One‐year OS rates were 99.3% versus 98.9% (HR = 0.96; 95% CI, 0.77–1.2), 72.6% versus 76.6% (HR = 1.28; 95% CI, 0.95–1.72), 96.6% versus 97.8% (HR = 1.09; 95% CI, 0.61–1.94), and 15.5% versus 15.1% (HR = 0.99; 95% CI, 0.72–1.37), in the treatment groups.ConclusionsDespite a decrease in the number of new BCs, there was no tumor stage shift, and OS did not vary.

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Section: Introductionmentioning

confidence: 99%

Impact of the COVID‐19 pandemic on clinical presentation, treatments, and outcomes of new breast cancer patients: A retrospective multicenter cohort study

Guével,

Priou,

Lamé

et al. 2023

Cancer Medicine

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Impact of the COVID-19 Pandemic on Tumor Stage and Pathohistological Parameters of Vulvar Cancer

Klamminger,

Bitterlich,

Nigdelis

et al. 2024

JCM

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Background/Objectives: Vulvar cancer (VC) comprises a small fraction of female neoplasms with notable high-incidence clusters among German regions. Despite a proposed impact of nationwide lockdowns in response to the COVID-19 pandemic on oncological diseases, the effect on VC staging and tumor characteristics remains yet to be resolved; therefore, analyzing pathological data from patients with squamous cell VC pre-, during, and post-COVID in a high-incidence region may offer insights into potential epidemiological and clinical trends. Methods: We identified a total of 90 patients who were diagnosed at the Institute of Pathology, University Hospital Saarland, between 2018 and 2023, and defined three distinct cohorts: a pre-COVID cohort (2018–2019), a COVID cohort (2020–2021), and a post-COVID cohort (2022–2023). Histomorphological data were collected from the individual patient reports and statistically analyzed using Fisher’s exact test or the Kruskal–Wallis test. Results: Although we found no statistically significant differences in age, T-stage, perineural infiltration, blood vessel infiltration, resection status, grading, or resection margin between our three cohorts, surprisingly, we determined a greater extent of lymphovascular infiltration (Fisher’s exact test; p = 0.041), as well as deeper tumor infiltration depth (Kruskal–Wallis test; p < 0.001) before the COVID-19 pandemic. Furthermore, we did not identify any soft indications of abnormalities in patient care within our center (unchanged status of the resection margins across all three cohorts). Conclusions: Our results clearly do not support a negative affection of clinical or pathobiological characteristics of VC during or after the pandemic. However, final assessments regarding the pandemic’s effect on VC require additional study approaches in various regions, preferably with future extended timeframes of a longer follow-up.

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Effect of the COVID-19 Pandemic on the Management of Breast Cancer Patients

Dalda,

Akbulut,

Kucukakcali

et al. 2024

JCM

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Background: The COVID-19 pandemic has significantly affected breast cancer patients by causing delays in diagnosis and treatment processes. This study aims to investigate the effects of the pandemic on the treatment process and short-term outcomes of breast cancer patients. Methods: This retrospective, cross-sectional, single-center study included 414 patients who underwent surgery for breast cancer at the Inonu University General Surgery Clinic between March 2018 and June 2021. The patients were divided into two groups: pre-pandemic (Pre-COVID-19; n = 240) and pandemic (COVID-19 Era; n = 174) periods. The groups were compared in terms of demographic, clinical, and histopathological variables. Results: During the pandemic period, the use of neoadjuvant therapy (from 21.3% to 34.5%) and preoperative PET-CT imaging (from 80.4% to 90.8%) rates increased, while breast-conserving surgery (from 27.9% to 19.0%) and the presence of comorbid diseases (from 45.0% to 29.9%) decreased significantly. While there was no significant difference between the groups in terms of the time from diagnosis to surgery (25 vs. 28.5 days, p = 0.121), the time to report the pathology result after surgery decreased during the pandemic period (28 vs. 23 days, p < 0.001). There was no significant difference between the groups in terms of immunohistochemical (ER, PR, Ki-67, E-cadherin, and c-erbB2), histopathological (lymphovascular invasion, perineural invasion, comedo necrosis, modified Bloom–Richardson grade, and TNM classification), and clinical (recurrence, metastasis, and axillary lymph node metastasis) features of the tumor. The mortality rate in the Pre-COVID-19 group (7.1%) was significantly higher than in the COVID-19 Era group (2.3%) (p = 0.049). Finally, in terms of the survival analysis, a statistically significant difference was found between the Pre-COVID-19 and COVID-19 Era groups in terms of the mean follow-up duration of the patients (p = 0.044). Conclusions: The study results show that the use of neoadjuvant therapy and radical surgery preference increased in breast cancer treatment during the pandemic period, but there was no significant change in tumor biology and histopathological features. Breast-conserving surgery rates, comorbidity rates, and pathology reporting times were significantly shortened. Long-term follow-up periods of 3 and 5 years are needed to see the impact of the pandemic on breast cancer patients.

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Impact of Covid-19 on breast cancer stage at discovery, and time to treatment in Cote d’Or, France

Cited by 3 publications

References 27 publications

Impact of the COVID‐19 pandemic on clinical presentation, treatments, and outcomes of new breast cancer patients: A retrospective multicenter cohort study

Impact of the COVID‐19 pandemic on clinical presentation, treatments, and outcomes of new breast cancer patients: A retrospective multicenter cohort study

Impact of the COVID-19 Pandemic on Tumor Stage and Pathohistological Parameters of Vulvar Cancer

Effect of the COVID-19 Pandemic on the Management of Breast Cancer Patients

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