The impact of the COVID-19 pandemic on clinical staging, pathological staging and surgical management of breast cancer patients.

Abstract

This study analyzes the impact of the first six lockdown months during the COVID-19 pandemic on breast cancer (BC) patients at a regional cancer center in western Poland (Greater Poland region). Patient age, clinical stage, pathological stage, surgical management, and use of neoadjuvant therapy (NT) for patients diagnosed with BC during the pandemic (March-August 2020, n = 290) were compared with pre-COVID-19 data (March-August 2019, n = 405). There were statistically significant differences in the average age (58.2 pre-COVID-19 vs. 55.9 during COVID-19, p = 0.014), clinical stage (p = 0.017) with a stage shift (stage I being dominant pre-pandemic, stage II during the pandemic). Additionally, when comparing the 2019 and 2020 groups, there were statistically significant differences in clinically node-positive cases (27% vs. 37%, p = 0.007), pathologically node-positive cases (26% vs. 34%, p = 0.014), and NT use (27% vs. 43%, p = 0.001). Moreover, there was a notable increase in the prevalence of mastectomies from 44% to 53% (p = 0.017) and axillary lymph node dissections from 27% to 33% (p = 0.029). The first six months of the COVID-19 pandemic had a discernible impact on BC patients in the Greater Poland region. Changes in patient age, clinical stage, pathological stage, and treatment approach were observed during this period. These findings underscore the importance of further research and adaptations in healthcare delivery to address the evolving needs of BC patients during times of crisis.