Impact of the COVID‐19 pandemic on a breast cancer surgery program. Observational case‐control study in a COVID‐free hospital

Nebril, Benigno Acea; Novoa, Alejandra García; García-Jiménez, Lourdes; Escribano-Posada, Carla; Díaz-Carballada, Carlota; Bouzón-Alejandro, Alberto; Conde-Iglesias, Carmen

doi:10.1111/tbj.14037

Cited by 11 publications

(30 citation statements)

References 5 publications

(10 reference statements)

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“…14 Similar analyses in Europe demonstrated decreases in breast reconstruction after mastectomy and shortened courses of radiation in some circumstances in 2020 compared with 2019 without evidence of surgical, chemotherapy, or radiation delays; however, studies like these assume utilization rates are constant over time when that may not be the case. 24,25 In this study, we found that almost half of our patients with BC had their care disrupted by the COVID-19 pandemic. These care delays and/or changes were seen across all modalities of care.…”

Section: Care Delivery Delays And/or Changes By Modalitymentioning

confidence: 74%

Care Delivery Impact of the COVID-19 Pandemic on Breast Cancer Care

Satish¹,

Raghunathan²,

Prigoff

et al. 2021

JCO Oncology Practice

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PURPOSE: COVID-19 has altered healthcare delivery. Previous work has focused on patients with cancer and COVID-19, but little has been reported on healthcare system changes among patients without COVID-19. METHODS: We performed a retrospective study of patients with breast cancer (BC) in New York City between February 1, 2020, and April 30, 2020. New patients were included as were patients scheduled to receive intravenous or injectable therapy. Patients with COVID-19 were excluded. Demographic and treatment information were obtained by chart review. Delays and/or changes in systemic therapy, surgery, radiation, and radiology related to the pandemic were tracked, along with the reasons for delay and/or change. Univariate and multivariable analysis were used to identify factors associated with delay and/or change. RESULTS: We identified 350 eligible patients, of whom 149 (42.6%) experienced a delay and/or change, and practice reduction (51.0%) was the most common reason. The patients who identified as Black or African American, Asian, or Other races were more likely to experience a delay and/or change compared with White patients (Black, 44.4%; Asian, 47.1%; Other, 55.6%; White, 31.4%; P = .001). In multivariable analysis, Medicaid compared with commercial insurance (odds ratio [OR], 3.04; 95% CI, 1.32 to 7.27) was associated with increased odds of a delay and/or change, whereas stage II or III BC compared with stage I (OR, 0.38; 95% CI, 0.15 to 0.95; and OR, 0.28; 95% CI, 0.08 to 0.092, respectively) was associated with decreased odds of a delay and/or change. CONCLUSION: Almost half of the patients with BC without COVID-19 had a delay and/or change. We found racial and socioeconomic disparities in the likelihood of a delay and/or change. Further studies are needed to determine the impact these care alterations have on BC outcomes.

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Section: Care Delivery Delays And/or Changes By Modalitymentioning

confidence: 74%

Care Delivery Impact of the COVID-19 Pandemic on Breast Cancer Care

Satish¹,

Raghunathan²,

Prigoff

et al. 2021

JCO Oncology Practice

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“…However, there are studies reporting that safe surgery can be performed under appropriate conditions during the pandemic period (12)(13)(14)(15)(16)(17)(18)(19)34). In the COVIDSurg group's study involving 9,171 patients, postoperative COVID-19 infection rate and pulmonary complication rates were lower in the COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas), and they recommended that dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and future COVID-19 outbreaks (17).…”

Section: Discussionmentioning

confidence: 99%

Has the COVID-19 Pandemic Affected Breast Cancer Stage and Surgical Volume?

Kara

Arikan²,

Dülgeroğlu³

et al. 2022

Front. Surg.

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BackgroundThis study investigates the effects of COVID-19 on the breast cancer stage and the volume of breast cancer surgery in a specialized breast institute.MethodsData of 332 patients who were diagnosed and treated for breast cancer between December 2019 and November 2020 were evaluated retrospectively according to periods of pandemic.ResultsA significant decrease in the number of operations, especially upfront surgeries rather than surgeries after neoadjuvant chemotherapy, was detected in the early period of the COVID-19 pandemic. It was found that patients with complaints were mostly admitted during this period (p = 0.024). No statistical significance was found for age, sex, side of the tumor, type of tumor, surgery to breast, and axilla. Following the early period of the pandemic, it was observed that patients with mostly luminal, early-stage, and less axillary nodal involvement (p < 0.05) were admitted, and as a result, it was founded that upfront surgeries increased, although no change in TNM staging was observed. However, it did affect the decision of initial treatment. Thus, the number of upfront surgeries was significantly higher than the NCT group (p = 0.027) following the early period.ConclusionSurgical volume is significantly affected in the early period of the COVID-19 pandemic. To overcome overload due to delayed surgeries related to pandemics, some hospitals should be spared for oncological treatments. Following the early period, mostly luminal type, early-stage patients were admitted, probably because of increased self-awareness and short wave duration, but the breast cancer stage was not affected.

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“…Past literature has found that among caregivers, depression and anxiety were higher in Black or African Americans than NHW women 50 , but other literature has reported that mental health symptoms increased with level of care 51 . It is also possible that COVID-19 experiences vary based upon geographic location within the US (urban, suburban, rural), and although not the case within the current study perhaps due to invariability, has been highlighted in past literature among the general population 45 , 52 and reproductive cancer patients 53 , 54 , noting that those living in rural areas were more likely to experience greater anxiety than those living in urban areas. Due to the recency of the COVID-19 pandemic in conjunction with its effect on both cancer patients, survivors, and those at increased risk for cancer like the women in this study, this topic remains relatively new and suggests the importance of researching this further.…”

Section: Discussionmentioning

confidence: 74%

COVID-19 experiences predicting high anxiety and depression among a sample of BRCA1/BRCA2-positive women in the US

Dibble

Connor

2021

Sci Rep

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During the COVID-19 pandemic, breast and ovarian cancer survivors experienced more anxiety and depression than before the pandemic. Studies have not investigated the similarities of this trend among BRCA1/2-positive women who are considered high risk for these cancers. The current study examines the impact of COVID-19 experiences on anxiety and depression in a sample of BRCA1/2-positive women in the U.S. 211 BRCA1/2-positive women from medically underserved backgrounds completed an online survey. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for associations between COVID-19 experiences and self-reported anxiety and depression stratified by demographic factors. Overall, women who reported COVID-19 stigma or discrimination (aOR, 5.14, 95% CI [1.55, 17.0]) experienced significantly more depressive symptoms than women who did not report this experience. Racial/ethnic minority women caring for someone at home during COVID-19 were 3.70 times more likely (95% CI [1.01, 13.5]) to report high anxiety while non-Hispanic white women were less likely (aOR, 0.34, 95% CI [0.09, 1.30], p interaction = 0.011). To date, this is the first study to analyze anxiety and depression considering several COVID-19 predictors among BRCA1/2-positive women. Our findings can be used to inform future research and advise COVID-19-related mental health resources specific to these women.

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Impact of the COVID‐19 pandemic on a breast cancer surgery program. Observational case‐control study in a COVID‐free hospital

Cited by 11 publications

References 5 publications

Care Delivery Impact of the COVID-19 Pandemic on Breast Cancer Care

Care Delivery Impact of the COVID-19 Pandemic on Breast Cancer Care

Has the COVID-19 Pandemic Affected Breast Cancer Stage and Surgical Volume?

COVID-19 experiences predicting high anxiety and depression among a sample of BRCA1/BRCA2-positive women in the US

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