Breast imaging, breast surgery, and cancer genetics in the age of COVID‐19

Abstract

BACKGROUND: The objective of the current study was to provide insight into the effect of coronavirus disease 2019 (COVID-19) on breast cancer screening, breast surgery, and genetics consultations. METHODS: User data from a risk assessment company were collected from February 2 to April 11, 2020. The use of risk assessment was used as a proxy for the use of 3 breast cancer services, namely, breast imaging, breast surgery, and genetics consultation. Changes in the use of these services during the study period were analyzed. RESULTS: All 3 services experienced significant declines after the COVID-19 outbreak. The decline in breast surgery began during the week of March 8, followed by breast imaging and genetics consultation (both of which began during the week of March 15). Breast imaging experienced the most significant reduction, with an average weekly decline of 61.7% and a maximum decline of 94.6%. Breast surgery demonstrated an average weekly decline of 20.5%. When surgical consultation was stratified as breast cancer versus no breast cancer, the decrease among in non-breast cancer patients was more significant than that of patients with breast cancer (a decline of 66.8% vs 11.5% from the pre-COVID average weekly volume for non-breast cancer patients and patients with breast cancer, respectively). During the week of April 5, use of genetics consultations dropped to 39.9% of the average weekly volumes before COVID-19. CONCLUSIONS: COVID-19 has had a significant impact on the number of patients undergoing breast cancer prevention, screening, diagnosis, and treatment. Cancer 2020;126:4466-4472.

Operational Impacts of the Coronavirus Disease 2019 (COVID-19) Pandemic and Early Recovery Trends: University of Washington Anatomic Pathology Experience

“…The effects of the COVID-19 pandemic on reduction in volume in specific sectors of healthcare have been demonstrated in other studiesexamples including but not limited to breast surgeries, breast screening, trauma cases, emergency visits, imaging, and plastic surgery emergencies. 11,12,13,14,15 Similarly, our study shows a reduction in specimen volume, which occurred across all aspects of the clinical service. This reduction primarily followed the trend of institutional and governmental polices on non-urgent procedure bans, which were being informed by the number of COVID-19 cases.…”

“…These findings are consistent with recommendations to avoid delays in many surgical oncologic cases 18,19 , and also with a study that found oncologic breast cases had less volume loss than non-oncologic breast cases. 11 The continuance of complex oncologic surgeries is also an explanation for the relatively stable demand for the intraoperative consultation service before and after non-urgent procedure restrictions. While the total number of surgical cases needing intraoperative consultation declined, the total number of parts to cases needing intraoperative consultation remained relatively the same, which we infer to reflect continuance of complex oncologic resections requiring several margin assessments (such as composite resections in the head and neck).…”

Impact of COVID-19 on Breast Imaging Practice Operations and Recovery Efforts: A North American Study

“…Although breast imaging experienced the most significant reduction in patient volume during the 2020 COVID-19 pandemic, other breast care services such as breast surgery and genetic counseling were also significantly impacted ( 24 ). Therefore, recovery of operations and efforts to mitigate the impact of delayed breast care should be undertaken in a multidisciplinary fashion ( 25 ).…”

Challenges of Genomic Testing for Hereditary Breast and Ovarian Cancers

“…However, it has been postulated that the previously established use of telemedicine in genetics likely mitigated this impact. 27 …”