Pattern of breast cancer presentation during the COVID-19 pandemic: results from a cohort study in the UK

Abstract

Background: This study aimed to explore the hypothesis that the stage of breast cancer at initial diagnosis in 2020 is more advanced compared with 2019. Methods: Tumor, node, metastasis and Union for International Cancer Control (UICC) stages of new breast cancer diagnoses at the Bucks Breast Unit from May to October 2019 and 2020 were reviewed. A p < 0.05 was considered significant. Results: Average UICC stage increased from 1a in 2019 to 2a in 2020 (p < 0.01). Excluding cancers detected through screening, UICC stage still increased from 1b in 2019 to 2a in 2020 (p = 0.0184). There was a significant increase in the percentage of node-positive patients (p = 0.0063) and patients with metastatic disease (p = 0.0295) on initial presentation. Conclusion: Overall, patients presented with higher UICC stages and more node-positive and metastatic disease on initial diagnosis in 2020 compared with 2019.

The impact of the COVID‐19 pandemic on cancer diagnosis based on pathology notifications: A comparison across the Nordic countries during 2020

“…Similarly, Dutch data on colorectal cancer found decreases in incidence, particularly for stage I tumours 34 . From the UK, a shift towards more advanced breast cancer stages was reported between May and October 2020 after a substantial drop from 43.8% to 9.2% screen‐detected cases compared to 2019 35 . Another study from the UK reported reductions in number of low‐stage cases of cervical cancer in the early phase of 2020, 36 while no difference in pathological stage of skin cancer was found in the autumn of 2020 (Oct‐Dec) when referral rates where back to normal levels 37 .…”

“… 34 From the UK, a shift towards more advanced breast cancer stages was reported between May and October 2020 after a substantial drop from 43.8% to 9.2% screen‐detected cases compared to 2019. 35 Another study from the UK reported reductions in number of low‐stage cases of cervical cancer in the early phase of 2020, 36 while no difference in pathological stage of skin cancer was found in the autumn of 2020 (Oct‐Dec) when referral rates where back to normal levels. 37 In Denmark, a recent study did not find any significant changes in stage distribution across seven major cancer sites between 2019 and 2020.…”

A systematic review of the impact of the COVID-19 pandemic on breast cancer screening and diagnosis

“…An initial 2451 citations were identified for title and abstract screening, of which 77 were eligible for inclusion ( Fig. 1 ) [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] ,…”

Can patients with asymptomatic SARS-CoV-2 infection safely undergo elective surgery?

“…For cancer, emerging data suggest upstaged disease presentations and poorer one-year survival outcomes among patients with delayed cancer surgery. 20 Among patients awaiting elective surgery, such as joint arthroplasty or heart valve replacement, a worsening of their condition while waiting is likely to increase their physical and mental suffering and make future treatment technically challenging and less likely to succeed. 2,21 In addition, the impacts on patients waiting for minor procedures, for example revision of perianal seton, removal of metalwork, bunionectomy, etc.…”

“…Unfortunately, the degree of morbidity associated with delayed surgery or undiagnosed surgical pathology is only beginning to be understood. For cancer, emerging data suggest upstaged disease presentations and poorer one-year survival outcomes among patients with delayed cancer surgery 20 . Among patients awaiting elective surgery, such as joint arthroplasty or heart valve replacement, a worsening of their condition while waiting is likely to increase their physical and mental suffering and make future treatment technically challenging and less likely to succeed 2 , 21 .…”