Background/Aim: Corona virus infection dramatically spread worldwide during 2020 and extraordinary restrictions have been implemented in order to reduce viral transmission. These measures compelled a complete restructuring of the health system, including temporary cancer screening suspension and a significant slow-down in cancer diagnoses and treatments. Case Report: We report five cases of extremely advanced breast cancer referred to our Department amid the COVID-19 pandemic. These patients exhibited a poor prognosis or worse quality of life due to their oncological disease. Conclusion: In our opinion, both the slow-down of diagnosis and treatment of oncological disease and anxiety over COVID-19 influenced this presentation. Moreover, other patients were unable to receive palliative care. Hopefully, these cases will not develop into extremely advanced-stage disease, and we will be able to provide at least the necessary palliative care.Breast oncological disease is the most commonly diagnosed female malignancy. It is the second leading cause of cancer death among women (1). Early diagnosis is important for improving patient prognosis and guaranteeing a conservative treatment. (2, 3).Infection with a novel corona virus, SARS-CoV-2, dramatically spread worldwide during the 2020 (3). Due to its rapid viral transmission and high associated mortality, on March 10, 2020, the Italian government, similarly to other governments throughout the world, has implemented exceptional constraints (4-6) in order to hinder viral transmission. These necessary measures forced a complete restructuring of the health system and resource reallocation in favor of patients with 8).Amidst the pandemic, especially during the first lockdown, only urgent medical treatments were guaranteed, at the expense of diagnostic procedures and oncological therapies, which suffered significant slowdown, with crucial delays in diagnoses and treatments (9). Moreover, Covid-19related anxiety also caused further diagnostic and therapeutic delays (10), consequently increasing the number of advanced breast cancer cases (9).Here we report five cases of patients with extremely advanced breast cancer, diagnosed during the pandemic as a possible effect of COVID-19-associated anxiety.This work is reported following the surgical case report guidelines and written consent from all the patients was obtained.
Case ReportCase 1. A 52-year-old Caucasian woman, a former smoker of 4.75 pack years, was admitted to the Emergency Department for a lipothymic episode. Family history was negative for oncological or cardiovascular conditions and no comorbidities were reported.Physical examination of the breast revealed an ulcerated hemorrhagic lesion on the right gland, with hard-ligneous consistency involving all the breast and extending to the 2331 This article is freely accessible online.