The COVID-19 outbreak may be associated to a reduced level of care for breast cancer. A comparative study with the pre-COVID era in an Italian Breast Unit

Fancellu, Alessandro; Sanna, Valeria; Piredda, C.; Ariu, L.; Piana, Gian Quirico; Deiana, Giulia; Cottu, Pietrina; Giuliani, Giuliana; Porcu, Alberto

doi:10.1016/s0959-8049(20)30562-1

Cited by 5 publications

(27 citation 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: 70%

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: 70%

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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“…The eligible studies delivered data on variant oncological disciplines including central nervous system (CNS), thyroid, thoracic, breast, colorectal, hepatocellular, endocrine, genitourinary, prostate cancer, skin and soft tissue sarcomas [ [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] ]. Of these included studies, eight evaluated surgical procedures for breast cancer [ 23 , 25 , 32 , 37 , [39] , [40] , [41] , [42] ]. In addition, six studies described the waiting time between pathological examination or diagnosis of cancer and the date the surgical procedure was performed [ 20 , [23] , [24] , [25] , 39 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of these included studies, eight evaluated surgical procedures for breast cancer [ 23 , 25 , 32 , 37 , [39] , [40] , [41] , [42] ]. In addition, six studies described the waiting time between pathological examination or diagnosis of cancer and the date the surgical procedure was performed [ 20 , [23] , [24] , [25] , 39 , 40 ]. Of these studies, three described shorter waiting times compared to pre-pandemic practice, of 0.5, 3 and 14 days, respectively [ 20 , 24 , 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of these studies, three described shorter waiting times compared to pre-pandemic practice, of 0.5, 3 and 14 days, respectively [ 20 , 24 , 39 ]. The remaining three studies showed minimally prolonged waiting times compared to pre-pandemic practice, of 4.0, 2.7 and 0.4 days, respectively [ 23 , 25 , 40 ]. In addition, all of these studies reported information regarding performed breast cancer procedures [ 23 , 25 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

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Systematic review and meta-analysis determining the effect of implemented COVID-19 guidelines on surgical oncology volumes and clinical outcomes

et al. 2022

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“…The pandemic resulted in a significant reduction in diagnostic and therapeutic NM procedures that may have reflected a reduced level of care for patients with diseases other than COVID-19, such as cancer or acute cardiovascular disease ( 5 , 41 ). Healthcare systems struggled to maintain the standard of care for these patients ( 43 , 44 ). Additionally, many patients avoided seeking medical care because of fear of becoming infected with the coronavirus while in the hospital.…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on Nuclear Medicine in Europe

Kirienko

Telo

Hustinx

et al. 2022

Seminars in Nuclear Medicine

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The COVID-19 pandemic has profoundly changed hospital activities, including nuclear medicine (NM) practice. This review aimed to determine and describe the impact of COVID-19 on NM in Europe and critically discuss actions and strategies applied to face the pandemic. A literature search for relevant articles was performed on PubMed, covering COVID-19 studies published up until January 21, 2021. The findings were summarized according to general and specific activities within the NM departments. The pandemic strongly challenged NM departments: a reduction in the workforce has been experienced in almost every centre in Europe due to personnel diagnosed with COVID-19 and other reasons related to the coronavirus. NM departments introduced procedures to limit COVID-19 transmission, including environmental and personal hygiene, social distancing, rescheduling of non–high-priority procedures, the correct use of personal protective equipment, and prompt identification of suspect COVID-19 cases. A proportion of the departments experienced a delay in radiopharmaceuticals supply or technical assistance during the pandemic. Furthermore, the pandemic resulted in a significant reduction of diagnostic and therapeutic NM procedures, as well as a reduced level of care for patients affected by diseases other than COVID-19, such as cancer or acute cardiovascular disease. Telemedicine services have been set up to maintain medical assistance for patients. COVID-19 pandemic has reshaped human work resources, patient's diagnostic and therapeutic management, operative models, radiopharmaceutical supplies, teaching, training and research of NM departments. Limits of availability of resources emerged. Nonetheless, we have to provide continuity in care, especially for fragile patients, maintaining infection control measures. Challenges that have been faced should reshape our vision and get us prepared for the future.

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The COVID-19 outbreak may be associated to a reduced level of care for breast cancer. A comparative study with the pre-COVID era in an Italian Breast Unit

Cited by 5 publications

References 0 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

Systematic review and meta-analysis determining the effect of implemented COVID-19 guidelines on surgical oncology volumes and clinical outcomes

The Impact of COVID-19 on Nuclear Medicine in Europe

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