Impact of the COVID-19 pandemic on the pathologic diagnosis and treatment of breast cancer in a university hospital in Brazil

Abstract

Abstract Purpose The COVID-19 pandemic has led to the need for extraordinary restrictions and adjustments in health services, which may have compromised cancer screening and oncological treatments. The aim of our retrospective study was to evaluate the impact of the COVID-19 pandemic on breast cancer pathologic diagnosis, presentation, and treatment in a university hospital in Brazil. Materials and methods We extracted data from the medical records of all patients who were diagnosed with breast cancer and underwent treatment in a Southeast University Hospital in Brazil from March to December between 2018 and 2021. The primary objective was to compare breast cancer diagnosis, stage, and oncology treatments during the COVID-19 pandemic (2020–2021) with a prepandemic control cohort (2018–2019). Results We collected data for 116 patients and 500 breast surgical specimens. There was a -12% decline in the diagnosis of new cases of breast cancer during the pandemic. The decrease was most pronounced when comparing 2019 and 2020 (-50%), and a recovery in the number of diagnoses was noted in 2021 compared to 2019 (+ 7.1%). In terms of therapeutic surgical approaches, an increase of 29.73% occurred during the pandemic period. The increase was most pronounced when comparing 2018 and 2020 (+ 41.18%). Overall, stage distribution and other tumor characteristics did not show statistically significant differences between the pandemic and prepandemic cohorts. Conclusions Our results showed a decrease in the number of new breast cancer diagnoses (-12%) during the pandemic compared to the prepandemic period. However, the number of therapeutic surgical approaches performed increased, and a recovery in the number of breast cancer diagnoses during 2021 has been noticed. Concerted measures are needed to minimize the long-term negative impact of the COVID-19 pandemic on delayed diagnosis.