25 - 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

Abstract

Background: The recent COVID-19 pandemic has caused profound changes on the health-care systems as well as deleterious repercussions on the care of patients with cancer. In this comparative study, we sought to evaluate the effects the COVID-19 pandemic on the surgical management of breast cancer in a Breast Unit belonging to an Italian region with a low incidence of COVID-19 infection. Methods: Eighty-three patients were included, of whom 41 received surgery during the heights of the pandemic (Group A-operated on in March and April 2020), and 42 during the same period (March-April) of the year 2019 (Group B). Clinicopathological characteristics and surgical outcomes were compared between the two groups Results: There were no significant differences in the baseline characteristics of the two groups in regard to age (p = 0.62), tumour size (p = 0.25), grade (p = 0.27), histology (p = 0.43), positive lymph nodes (p = 0.35), ER positive status (0.35). Waiting time for surgery was slightly longer in Group A (49.11 vs 46.39, p = 0.38). Patients receiving immediate breast reconstruction were significantly less in patients of Group A (p < 0.001). Use of sentinel node biopsy was similar in the two groups (p = 0.84). Hospital stay was longer in patients of Group B (p = 0.008). Use of regional nerve blocks was lower in the Group A (p < 0.001). Conclusions: Patients operated on during the height of pandemic were less likely to receive immediate reconstruction and regional nerve blocks. Health-care services should develop reliable and useful measures aiming to maintain the highest standards of care in case of new pandemic, and extraordinary events in general. No conflict of interest.