The impact of COVID-19 in breast cancer diagnosis: a casuistic from our center

Abstract

Background: The COVID-19 pandemic has posed significant pressures on healthcare system resources and treatment decisions at the provider and patient level. Regarding breast imaging, several articles demonstrated sizable decreases in imaging volumes, particularly in mammography examinations, due to lockdown recommendations by governments, concerns of patients for the potential virus exposure at hospitals and delaying non-mandatory screening examinations in most facilities. So, how did the COVID-19 affect our center? Materials and Methods: We performed a retrospective study, comparing the group of patients admitted in our hospital with breast cancer diagnosis, older than 18 years, between march and december 2019, with the same group of patients admitted between march and december of 2020.We analyzed the data regarding time periods between the first appointment and the different imaging tests. Results: 212 patients were included in our study, 122 from 2019 and 90 from 2020, and 135 patients excluded.The time between the first appointment and the biopsy increased 27.6 days from 2019 to 2020. Conversely, there was a reduction of the time between the biopsy and the anatomopathological result (13.3 days).As for the different imaging tests, we reported an increase from the first appointment to axillary ultrasound, MRI, and bone scintigraphy, in 11.9, 20.2 and 25.2 days, respectively. Conclusions: As we would expect, we observed a delayed response from the imageology department during the pandemic period. This was probably due to a redistribution of human and technical resources, which resulted in less availability for elective exams.On the other hand, the anatomopathological response was faster during this period, perhaps associated with a decrease in work volume, directly related to a reduction in elective surgeries and benign pathologies.The COVID-19 pandemic significantly affected the healthcare system resources, as we can confirm with this study. However, the true impact is yet to be seen, with delays in screening and diagnosis, which will probably result in thousands of excess cancer deaths over the next several years.