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

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.

A systematic review of the impact of the COVID-19 pandemic on breast cancer screening and diagnosis

“…An initial 2451 citations were identified for title and abstract screening, of which 77 were eligible for inclusion ( Fig. 1 ) [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] ,…”

Impact of COVID-19 on cancer screening in South Korea

“…However, multiple studies have reported that since the emergence of COVID-19, there have been considerable reductions in cancer screening, diagnostic services, endoscopic procedures, and screening-related tests such as biopsies and cervical cytology 3 – 8 . Similarly, in South Korea, the overall national cancer screening rate was reduced by 6.4% (55.6% in 2019 and 49.2% in 2020) 9 and breast cancer diagnoses were reduced by 9.9% in 2020 10 .…”

A Single-Center Audit of Symptomatic Breast Cancer Patient Referrals During COVID-19 Pandemic Restrictions

“…While the shortened 2ww time and increased cancer diagnosis in this study may help ease patients and public anxiety, the COVID-19 pandemic and its restrictions are associated with profound short- and long-term consequences for the patients, hospital organizations, and clinicians. It was anticipated that the reduced 2ww referral rate and breast cancer diagnosis would be followed by a surge in the 2ww referrals and advanced breast cancers after the pandemics [ 18 , 25 ]. It was also predicted that cancer mortality, including breast cancers, will worsen after the pandemic [ 8 , 10 ].…”

“…It was also predicted that cancer mortality, including breast cancers, will worsen after the pandemic [ 8 , 10 ]. Some studies have shown a rebound in the 2ww referral [ 12 , 16 , 17 , 26 ] and breast cancer diagnosis rates [ 16 , 25 ] and predicted a shift in breast cancer diagnosis from early to advanced stages following the COVID-19 pandemic [ 18 , 25 ]. Several specialist breast services have implemented telephone consultations and virtual meetings during the COVID-19 pandemic [ 27 ].…”