Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis, Presentation, and Patient Management
Introduction The COVID-19 pandemic caused delays in breast cancer management forcing clinicians to potentially alter treatment recommendations. This study compared breast cancer stage at diagnosis and rates of neoadjuvant therapy among women presenting to our institution before and during COVID-19....
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| Veröffentlicht in: | Annals of surgical oncology 2022-04, Vol.29 (4), p.2231-2239 |
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| creator | Tonneson, Jennifer E. Hoskin, Tanya L. Day, Courtney N. Durgan, Diane M. Dilaveri, Christina A. Boughey, Judy C. |
| description | Introduction
The COVID-19 pandemic caused delays in breast cancer management forcing clinicians to potentially alter treatment recommendations. This study compared breast cancer stage at diagnosis and rates of neoadjuvant therapy among women presenting to our institution before and during COVID-19.
Methods
Retrospective chart review of patients with a new breast cancer diagnosis from March 2020–August 2020 (during-COVID-19) were compared with March 2019–August 2019 (pre-COVID-19). We compared stage at diagnosis, clinical/demographic features, and neoadjuvant therapy use between the time periods.
Results
A total of 573 patients included: 376 pre-COVID-19, 197 during-COVID-19. Method of cancer detection was by imaging in 66% versus 63% and by physical findings/symptoms in 34% versus 37% of patients comparing pre-COVID-19 to during-COVID-19,
p
= 0.47. Overall clinical prognostic stage did not differ significantly (
p
= 0.39) between the time periods, nor did cM1 disease (2% in each period); 23% pre-COVID-19 and 27% during-COVID-19 presented with cN+ disease (
p
= 0.38).
Neoadjuvant therapy use was significantly higher during-COVID-19 (39%) versus pre-COVID-19 (29%,
p
= 0.02) driven by increased neoadjuvant endocrine therapy (NET) use (7% to 16%,
p
= 0.002), whereas neoadjuvant chemotherapy use did not change (22% vs. 23%,
p
= 0.72). In HR+/HER2− disease, NET use increased from 10% pre-COVID-19 to 23% during-COVID-19 (
p
= 0.001) with a significant increase in stage I patients (7 to 22%,
p
< 0.001) and nonsignificant increases in stage II (18 to 23%,
p
= 0.63) and stage III (9 to 29%,
p
= 0.29).
Conclusions
Breast cancer stage at diagnosis did not differ significantly during-COVID-19 compared with pre-COVID-19. More patients during-COVID-19 were treated with NET, which was significantly increased in stage I HR+/HER2− disease. |
| doi_str_mv | 10.1245/s10434-021-11088-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8609838</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2601483614</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-4b8c9ab8de2e048bcb9cbc362ef779921812f35098f45e5ebc6802161fa596513</originalsourceid><addsrcrecordid>eNp9kctuVDEMho8QiF7gBVigSGxY9EDuk2yQYErLSEWtxGUb5WR8pqnmJEOSQeLt6zKllC5YxbI__7bzd90LRt8wLtXbyqgUsqec9YxRY3r9qNtnClNSG_YYY6pNb7lWe91BrVeUspmg6mm3J6Rh3Bq238XFtPGhkTySdglkfv59cdwzSy58WsIUA8mJfCjgayNznwIU8qX5FRDfyHH0q5RrrEfkokCF1HyLOR0RbMX-FjFDPvuE-IThs-7J6NcVnt--h923k49f55_6s_PTxfz9WR_kTLZeDiZYP5glcKDSDGGwYQhCcxhnM2s5w81Hoag1o1SgYAja4A9oNnpltWLisHu3091shwmWAUcXv3abEidffrnso_u3kuKlW-WfzmgUFQYFXt8KlPxjC7W5KdYA67VPkLfVcU2ZNEIzieirB-hV3paE5yElqVJWao0U31Gh5FoLjHfLMOpunHQ7Jx3e4X476W6aXt4_467lj3UIiB1QsZRWUP7O_o_sNbRcqDY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2640559466</pqid></control><display><type>article</type><title>Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis, Presentation, and Patient Management</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Tonneson, Jennifer E. ; Hoskin, Tanya L. ; Day, Courtney N. ; Durgan, Diane M. ; Dilaveri, Christina A. ; Boughey, Judy C.</creator><creatorcontrib>Tonneson, Jennifer E. ; Hoskin, Tanya L. ; Day, Courtney N. ; Durgan, Diane M. ; Dilaveri, Christina A. ; Boughey, Judy C.</creatorcontrib><description>Introduction
The COVID-19 pandemic caused delays in breast cancer management forcing clinicians to potentially alter treatment recommendations. This study compared breast cancer stage at diagnosis and rates of neoadjuvant therapy among women presenting to our institution before and during COVID-19.
Methods
Retrospective chart review of patients with a new breast cancer diagnosis from March 2020–August 2020 (during-COVID-19) were compared with March 2019–August 2019 (pre-COVID-19). We compared stage at diagnosis, clinical/demographic features, and neoadjuvant therapy use between the time periods.
Results
A total of 573 patients included: 376 pre-COVID-19, 197 during-COVID-19. Method of cancer detection was by imaging in 66% versus 63% and by physical findings/symptoms in 34% versus 37% of patients comparing pre-COVID-19 to during-COVID-19,
p
= 0.47. Overall clinical prognostic stage did not differ significantly (
p
= 0.39) between the time periods, nor did cM1 disease (2% in each period); 23% pre-COVID-19 and 27% during-COVID-19 presented with cN+ disease (
p
= 0.38).
Neoadjuvant therapy use was significantly higher during-COVID-19 (39%) versus pre-COVID-19 (29%,
p
= 0.02) driven by increased neoadjuvant endocrine therapy (NET) use (7% to 16%,
p
= 0.002), whereas neoadjuvant chemotherapy use did not change (22% vs. 23%,
p
= 0.72). In HR+/HER2− disease, NET use increased from 10% pre-COVID-19 to 23% during-COVID-19 (
p
= 0.001) with a significant increase in stage I patients (7 to 22%,
p
< 0.001) and nonsignificant increases in stage II (18 to 23%,
p
= 0.63) and stage III (9 to 29%,
p
= 0.29).
Conclusions
Breast cancer stage at diagnosis did not differ significantly during-COVID-19 compared with pre-COVID-19. More patients during-COVID-19 were treated with NET, which was significantly increased in stage I HR+/HER2− disease.</description><identifier>ISSN: 1068-9265</identifier><identifier>ISSN: 1534-4681</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-021-11088-6</identifier><identifier>PMID: 34812981</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Breast cancer ; Breast Neoplasms - drug therapy ; Breast Neoplasms - therapy ; Breast Oncology ; Cancer therapies ; Chemotherapy ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; Diagnosis ; Endocrine therapy ; ErbB-2 protein ; Female ; Humans ; Medicine ; Medicine & Public Health ; Neoadjuvant Therapy ; Oncology ; Pandemics ; Patients ; Receptor, ErbB-2 ; Retrospective Studies ; Surgery ; Surgical Oncology</subject><ispartof>Annals of surgical oncology, 2022-04, Vol.29 (4), p.2231-2239</ispartof><rights>Society of Surgical Oncology 2021</rights><rights>2021. Society of Surgical Oncology.</rights><rights>Society of Surgical Oncology 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-4b8c9ab8de2e048bcb9cbc362ef779921812f35098f45e5ebc6802161fa596513</citedby><cites>FETCH-LOGICAL-c474t-4b8c9ab8de2e048bcb9cbc362ef779921812f35098f45e5ebc6802161fa596513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-021-11088-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-021-11088-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34812981$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tonneson, Jennifer E.</creatorcontrib><creatorcontrib>Hoskin, Tanya L.</creatorcontrib><creatorcontrib>Day, Courtney N.</creatorcontrib><creatorcontrib>Durgan, Diane M.</creatorcontrib><creatorcontrib>Dilaveri, Christina A.</creatorcontrib><creatorcontrib>Boughey, Judy C.</creatorcontrib><title>Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis, Presentation, and Patient Management</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Introduction
The COVID-19 pandemic caused delays in breast cancer management forcing clinicians to potentially alter treatment recommendations. This study compared breast cancer stage at diagnosis and rates of neoadjuvant therapy among women presenting to our institution before and during COVID-19.
Methods
Retrospective chart review of patients with a new breast cancer diagnosis from March 2020–August 2020 (during-COVID-19) were compared with March 2019–August 2019 (pre-COVID-19). We compared stage at diagnosis, clinical/demographic features, and neoadjuvant therapy use between the time periods.
Results
A total of 573 patients included: 376 pre-COVID-19, 197 during-COVID-19. Method of cancer detection was by imaging in 66% versus 63% and by physical findings/symptoms in 34% versus 37% of patients comparing pre-COVID-19 to during-COVID-19,
p
= 0.47. Overall clinical prognostic stage did not differ significantly (
p
= 0.39) between the time periods, nor did cM1 disease (2% in each period); 23% pre-COVID-19 and 27% during-COVID-19 presented with cN+ disease (
p
= 0.38).
Neoadjuvant therapy use was significantly higher during-COVID-19 (39%) versus pre-COVID-19 (29%,
p
= 0.02) driven by increased neoadjuvant endocrine therapy (NET) use (7% to 16%,
p
= 0.002), whereas neoadjuvant chemotherapy use did not change (22% vs. 23%,
p
= 0.72). In HR+/HER2− disease, NET use increased from 10% pre-COVID-19 to 23% during-COVID-19 (
p
= 0.001) with a significant increase in stage I patients (7 to 22%,
p
< 0.001) and nonsignificant increases in stage II (18 to 23%,
p
= 0.63) and stage III (9 to 29%,
p
= 0.29).
Conclusions
Breast cancer stage at diagnosis did not differ significantly during-COVID-19 compared with pre-COVID-19. More patients during-COVID-19 were treated with NET, which was significantly increased in stage I HR+/HER2− disease.</description><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - therapy</subject><subject>Breast Oncology</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>Diagnosis</subject><subject>Endocrine therapy</subject><subject>ErbB-2 protein</subject><subject>Female</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoadjuvant Therapy</subject><subject>Oncology</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Receptor, ErbB-2</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><issn>1068-9265</issn><issn>1534-4681</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kctuVDEMho8QiF7gBVigSGxY9EDuk2yQYErLSEWtxGUb5WR8pqnmJEOSQeLt6zKllC5YxbI__7bzd90LRt8wLtXbyqgUsqec9YxRY3r9qNtnClNSG_YYY6pNb7lWe91BrVeUspmg6mm3J6Rh3Bq238XFtPGhkTySdglkfv59cdwzSy58WsIUA8mJfCjgayNznwIU8qX5FRDfyHH0q5RrrEfkokCF1HyLOR0RbMX-FjFDPvuE-IThs-7J6NcVnt--h923k49f55_6s_PTxfz9WR_kTLZeDiZYP5glcKDSDGGwYQhCcxhnM2s5w81Hoag1o1SgYAja4A9oNnpltWLisHu3091shwmWAUcXv3abEidffrnso_u3kuKlW-WfzmgUFQYFXt8KlPxjC7W5KdYA67VPkLfVcU2ZNEIzieirB-hV3paE5yElqVJWao0U31Gh5FoLjHfLMOpunHQ7Jx3e4X476W6aXt4_467lj3UIiB1QsZRWUP7O_o_sNbRcqDY</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Tonneson, Jennifer E.</creator><creator>Hoskin, Tanya L.</creator><creator>Day, Courtney N.</creator><creator>Durgan, Diane M.</creator><creator>Dilaveri, Christina A.</creator><creator>Boughey, Judy C.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220401</creationdate><title>Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis, Presentation, and Patient Management</title><author>Tonneson, Jennifer E. ; Hoskin, Tanya L. ; Day, Courtney N. ; Durgan, Diane M. ; Dilaveri, Christina A. ; Boughey, Judy C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-4b8c9ab8de2e048bcb9cbc362ef779921812f35098f45e5ebc6802161fa596513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - therapy</topic><topic>Breast Oncology</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - epidemiology</topic><topic>Diagnosis</topic><topic>Endocrine therapy</topic><topic>ErbB-2 protein</topic><topic>Female</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoadjuvant Therapy</topic><topic>Oncology</topic><topic>Pandemics</topic><topic>Patients</topic><topic>Receptor, ErbB-2</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tonneson, Jennifer E.</creatorcontrib><creatorcontrib>Hoskin, Tanya L.</creatorcontrib><creatorcontrib>Day, Courtney N.</creatorcontrib><creatorcontrib>Durgan, Diane M.</creatorcontrib><creatorcontrib>Dilaveri, Christina A.</creatorcontrib><creatorcontrib>Boughey, Judy C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tonneson, Jennifer E.</au><au>Hoskin, Tanya L.</au><au>Day, Courtney N.</au><au>Durgan, Diane M.</au><au>Dilaveri, Christina A.</au><au>Boughey, Judy C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis, Presentation, and Patient Management</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>29</volume><issue>4</issue><spage>2231</spage><epage>2239</epage><pages>2231-2239</pages><issn>1068-9265</issn><issn>1534-4681</issn><eissn>1534-4681</eissn><abstract>Introduction
The COVID-19 pandemic caused delays in breast cancer management forcing clinicians to potentially alter treatment recommendations. This study compared breast cancer stage at diagnosis and rates of neoadjuvant therapy among women presenting to our institution before and during COVID-19.
Methods
Retrospective chart review of patients with a new breast cancer diagnosis from March 2020–August 2020 (during-COVID-19) were compared with March 2019–August 2019 (pre-COVID-19). We compared stage at diagnosis, clinical/demographic features, and neoadjuvant therapy use between the time periods.
Results
A total of 573 patients included: 376 pre-COVID-19, 197 during-COVID-19. Method of cancer detection was by imaging in 66% versus 63% and by physical findings/symptoms in 34% versus 37% of patients comparing pre-COVID-19 to during-COVID-19,
p
= 0.47. Overall clinical prognostic stage did not differ significantly (
p
= 0.39) between the time periods, nor did cM1 disease (2% in each period); 23% pre-COVID-19 and 27% during-COVID-19 presented with cN+ disease (
p
= 0.38).
Neoadjuvant therapy use was significantly higher during-COVID-19 (39%) versus pre-COVID-19 (29%,
p
= 0.02) driven by increased neoadjuvant endocrine therapy (NET) use (7% to 16%,
p
= 0.002), whereas neoadjuvant chemotherapy use did not change (22% vs. 23%,
p
= 0.72). In HR+/HER2− disease, NET use increased from 10% pre-COVID-19 to 23% during-COVID-19 (
p
= 0.001) with a significant increase in stage I patients (7 to 22%,
p
< 0.001) and nonsignificant increases in stage II (18 to 23%,
p
= 0.63) and stage III (9 to 29%,
p
= 0.29).
Conclusions
Breast cancer stage at diagnosis did not differ significantly during-COVID-19 compared with pre-COVID-19. More patients during-COVID-19 were treated with NET, which was significantly increased in stage I HR+/HER2− disease.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34812981</pmid><doi>10.1245/s10434-021-11088-6</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2022-04, Vol.29 (4), p.2231-2239 |
| issn | 1068-9265 1534-4681 1534-4681 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8609838 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Antineoplastic Combined Chemotherapy Protocols - therapeutic use Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - therapy Breast Oncology Cancer therapies Chemotherapy Coronaviruses COVID-19 COVID-19 - epidemiology Diagnosis Endocrine therapy ErbB-2 protein Female Humans Medicine Medicine & Public Health Neoadjuvant Therapy Oncology Pandemics Patients Receptor, ErbB-2 Retrospective Studies Surgery Surgical Oncology |
| title | Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis, Presentation, and Patient Management |
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