Repercussions of COVID-19 pandemic impacts on non-metastatic HER2-negative breast cancer diagnosis and neoadjuvant treatment over patients’ quality of life and mental health/ Repercussões dos impactos da pandemia COVID-19 no diagnóstico e tratamento neoadjuvante de câncer de mama HER2-negativo não metastático sobre a qualidade de vida e saúde mental das pacientes

Abstract

OBJECTIVE: To understand if COVID-19 pandemic impacts on delays in non-metastatic HER2-negative breast cancer diagnosis and in the beginning/development of neoadjuvant chemotherapy, as well as on changes in treatment plan to Paclitaxel intensification doses, impaired patients’ quality of life and mental health. METHODS: This is a cross-sectional study of 67 women diagnosed with non-metastatic HER2-negative breast cancer during the first sixteen months of COVID-19 pandemic and receiving neoadjuvant treatment due to pandemic impossibility of immediate definitive cancer surgery following the neoplasm diagnosis. Sociodemographic, Functional Assessment of Cancer Therapy Scale - General, Beck Anxiety and Depression Inventory were used for outcomes assessment. Inferential analysis was performed by Mann-Whitney, Pearson's chi-squared, and Fisher's exact tests. The adopted significance was 5%. RESULTS: The study revealed that the oncological diagnosis delays caused a worsening of the patients' physical (8 x 21; p = 0.001), functional (13 x 21; p = 0.03) and general (61 x 83; p = 0.004) well-being; retardment in the beginning of neoadjuvant chemotherapy decreased physical well-being (13 x 21; p = 0.01). Changes in treatment plan, to Paclitaxel doses intensification, had a negative effect on functional well-being (20 x 25.5; p = 0.04). COVID-19 pandemic impacts on neoplasm diagnosis and neoadjuvant treatment delays were also associated with psychosocial manifestations, including higher levels of severe anxiety (60% x 14.5%; p = 0.03 and 40% x 14%; p = 0.04) and depression (40% x 3.2%; p = 0.004 and 60% x 5.3%; p = 0.03) respectively. CONCLUSION: The present study shows that COVID-19 pandemic impacts on non-metastatic HER2-negative breast cancer patients’ diagnosis and neoadjuvant chemotherapy impaired patients' quality of life and mental health.