Breast imaging hindered during covid-19  pandemic, in Brazil

Bessa, Jordana de Faria

doi:10.11606/s1518-8787.2021055003375

Cited by 17 publications

(25 citation statements)

References 11 publications

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“…Table 3 compares the number of mammograms performed during the pandemic vs. the same time period before the pandemic. Reductions in screening mammography rates were reported in all studies and ranged from 53.8% to 22.2% among registry-based studies 20 , 35 , 44 and 80.0% to 9.8% among non-registry-based studies. 18 , 24 , 25 , 31 , 34 , 36 , 39 , 41 , 43 , 49 Figure 2 displays the results of the meta-analysis of mammographic screening rate ratios.…”

Section: Resultsmentioning

confidence: 85%

“…Therefore, 33 reports consisting of 31 studies formed the basis of this review. 18 – 50 A PRISMA flow diagram outlining the screening process is presented in Figure 1 . The list of excluded studies with reasons of exclusion is reported in Supplementary Table S2.…”

Section: Resultsmentioning

confidence: 99%

“…Our results suggest that almost half of the women eligible for breast cancer screening did not get their mammograms during the pandemic in comparison to 2019. This finding can likely be largely attributed to the suspension of most breast cancer screening activities in areas with high COVID-19 cases 18 , 20 , 24 as a result of the inability to maintain ‘safe distancing’ during breast imaging studies, given the short distance between the radiographer's face and the face of the patient, a distance that can be as little as 20–30 cm during the radiographic procedure. 54 , 55 In addition to the suspension of screening programs, we also note that the use of lockdown measures likely also significantly impacted screening and diagnosis rates.…”

Section: Discussionmentioning

confidence: 99%

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Assessing the impact of the COVID-19 pandemic on breast cancer screening and diagnosis rates: A rapid review and meta-analysis

Hamilton

2022

J Med Screen

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Objective The ongoing COVID-19 pandemic has caused an indefinite delay to cancer screening programs worldwide. This study aims to explore the impact on breast cancer screening outcomes such as mammography and diagnosis rates. Methods We searched Ovid MEDLINE, Ovid Embase, medRxiv and bioRxiv between January 2020 to October 2021 to identify studies that reported on the rates of screening mammography and breast cancer diagnosis before and during the pandemic. The effects of ‘lockdown’ measures, age and ethnicity on outcomes were also examined. All studies were assessed for risk of bias using the Newcastle-Ottawa Scale (NOS). Rate ratios were calculated for all outcomes and pooled using standard inverse-variance random effects meta-analysis. Results We identified 994 articles, of which 7 registry-based and 24 non-registry-based retrospective cohort studies, including data on 4,860,786 and 629,823 patients respectively across 18 different countries, were identified. Overall, breast cancer screening and diagnosis rates dropped by an estimated 41–53% and 18–29% respectively between 2019 and 2020. No differences in mammogram screening rates depending on patient age or ethnicity were observed. However, countries that implemented lockdown measures were associated with a significantly greater reduction in mammogram and diagnosis rates between 2019 and 2020 in comparison to those that did not. Conclusion The pandemic has caused a substantial reduction in the screening and diagnosis of breast cancer, with reductions more pronounced in countries under lockdown restrictions. It is early yet to know if delayed screening during the pandemic translates into higher breast cancer mortality.

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Section: Resultsmentioning

confidence: 85%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Assessing the impact of the COVID-19 pandemic on breast cancer screening and diagnosis rates: A rapid review and meta-analysis

Hamilton

2022

J Med Screen

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“…4 In diagnosis, it will lead to an upstaging of tumor worsening prognosis, reducing women's quality of life, demanding more resources to the health care system to treat more complex situations. 3 10 11 12 13…”

Section: Introductionmentioning

confidence: 99%

The COVID-19 Pandemic Impact on Breast Cancer Diagnosis: A Retrospective Study

Negrão

Cabello

Conz

et al. 2022

Rev Bras Ginecol Obstet

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Objective This study aimed to evaluate the diagnostic profile of breast cancer cases during the coronavirus disease 2019 (COVID-19) pandemic compared with the previous year. Methods It is a retrospective study of cases diagnosed by a reference service in the public health system of Campinas, SP, Brazil. Two periods were analyzed: March to October 2019 (preCOVID period) and March to October 2020 (COVID-period). All women diagnosed during the periods were included. The Chi-Squared or Fisher exact and Mann-Whitney tests were used. Results In the preCOVID and COVID periods, breast cancers were diagnosed, respectively, in 115 vs 59 women, and the mean ages at diagnosis were 55 and 57 years (p = 0.339). In the COVID period, the family history of breast cancer was more observed (9.6% vs 29.8%, p < 0.001), cases were more frequently symptomatic (50.4% vs 79.7%, p < 0.001) and had more frequently palpable masses (56.5% vs 79.7%, p = 0.003). In symptomatic women, the mean number of days from symptom to mammography were 233.6 (458.3) in 2019 and 152.1 (151.5) in 2020 (p = 0.871). Among invasive tumors, the proportion of breast cancers in stages I and II was slightly higher in the COVID period, although not significantly (76.7% vs 82.4%, p = 0.428). Also in the COVID period, the frequency of luminal A-like tumors was lower (29.2% vs 11.8%, p = 0.018), of triple-negative tumors was twice as high (10.1% vs 21.6%, p = 0.062), and of estrogen receptor-positive tumors was lower (82.2% vs 66.0%, p = 0.030). Conclusion During the COVID-19 pandemic, breast cancer diagnoses were reduced. Cases detected were suggestive of a worse prognosis: symptomatic women with palpable masses and more aggressive subtypes. Indolent tumors were those more sensitive to the interruption in screening.

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“…In Brazil, in the city of Fortaleza, the decrease of screening mammograms was up to 95% [ 10 ]. In a cross-sectional study of the Brazilian public health system, the decline in mammograms reached 42% all over the nation from 2019 to 2020 [ 11 ]. In the case of cervical cancer, a Californian study showed that during the pandemic, when the population was recommended to stay at home, cervical cancer screening rates decreased by 78% [ 12 ].…”

Section: Discussionmentioning

confidence: 99%