Delay in Breast Cancer Treatments During the First COVID-19 Lockdown. A Multicentric Analysis of 432 Patients.

Gianluca Vanni,Maria Cotesta,Agostino Chiaravalloti,Vittorio Lombardo,Jonathan Caspi,Francesca Combi,Saverio Muscoli,Lorenza Caggiati,Francesca Santori,Chiara Adriana Pistolese,Simona Papi,Giovanni Tazzioli,Antonella Grasso,Oreste Claudio Buonomo,Leonardo Palombi,Orsaria Paolo,Roberta Raselli,Vittorio Altomare,Francesca Cattadori,Marco Materazzo,Marco Pellicciaro,Rolando Maria D’Angelillo,D Palli

doi:10.21873/anticanres.14741

Abstract

Extraordinary restrictions aimed to limit Sars-CoV-2 spreading; they imposed a total reorganization of the health-system. Oncological treatments experienced a significant slowdown. The aim of our multicentric retrospective study was to evaluate screening suspension and surgical treatment delay during COVID-19 and the impact on breast cancer presentation. All patients who underwent breast surgery from March 11, 2020 to May 30, 2020 were evaluated and considered as the Lockdown group. These patients were compared with similar patients of the previous year, the Pre-Lockdown group. A total of 432 patients were evaluated; n=223 and n=209 in the Lockdown and Pre-lockdown-groups, respectively. At univariate analysis, waiting times, lymph-nodes involvement and cancer grading, showed a statistically significant difference (p<0.05). Multivariate analysis identified waiting-time on list (OR=1.07) as a statistically significant predictive factor of lymph node involvement. Although we did not observe a clinically evident difference in breast cancer presentation, we reported an increase in lymph node involvement.

Highlights

Sars-CoV-2 infection has dramatically spread worldwide since the beginning of 2020 (1)
Among the Lockdown group, preoperative diagnosis assessment was performed in 32 cases by cytological examination (15.7%) and in 187 by biopsy (92.1%)
In the comings months we might observe an increase in tumor dimensions and incidence of clinically evident lesions with a consequent increase of post-surgery treatments and worse quality of life

Summary

Introduction

Sars-CoV-2 infection has dramatically spread worldwide since the beginning of 2020 (1). Due to rapid human-tohuman transmission and in order to limit the viral spread, on March 10, 2020, the government has implemented extraordinary restrictions (2). These measures changed our daily routine and forced a reorganization of the Health system (3). Invasive breast surgeries (e.g. mastectomy) have decreased along the years. Both these favourable outcomes have been made possible partially thanks to the improvement in early breast cancer diagnosis achieved by the screening programs (9). The aim of our multicentric retrospective study was to evaluate the impact of screening suspension and treatment delay during the COVID-19 lockdown, on breast cancer clinical presentation, diagnosis and surgical treatments

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Discussion

Conclusion