Impact of COVID-19 On Breast Cancer Management: A Radiological Prespective from A Tertiary Centre

Differences in Age, Stage and Biology of Breast Cancer Presentations at A Private Breast Unit in Johannesburg Before and During The COVID-19 Pandemic

Objective

Prior to the 2020 Coronavirus disease 2019 (COVID-19) pandemic, breast cancer (BC) was already a major healthcare concern globally, including in South Africa (SA). The pandemic forced adjustments in BC management and may have also impacted BC presentation characteristics due to social behavior changes. The aim of this study was to describe BC presentations before and during the COVID-19 pandemic at a single facility in SA.

Materials and Methods

A retrospective record review was conducted to compare BC presentations before and during the COVID-19 pandemic. The "before" period spanned 11 January 2019 to 31 March 2020 and the "during" period spanned 1 April 2020 to 20 December 2021. The variables analysed included patient age, BC stage at presentation, and tumor biology.

Results

A total of 731 patients were seen in the "before" period, and 636 in the "during" period. While there was a significant (p<0.0001) decrease in the mean number of patients who presented to the unit per month during the pandemic, no significant differences were observed in age, BC stage at presentation, or tumor biology between the two study periods.

Conclusion

Despite a significant reduction in new BC cases during the COVID-19 pandemic in SA, patient age, BC stage, and tumor biology remained unchanged. The rapid implementation of digital tools for healthcare management is likely to have played an important role in maintaining patient access to care.

Breast cancer care amidst a pandemic: a scoping review to understand the impact of coronavirus disease 2019 on health services and health outcomes

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, health services for breast cancer (BC) have been disrupted. Our scoping review examines the impact of the COVID-19 pandemic on BC services, health outcomes, and well-being for women. Additionally, this review identifies social inequalities specific to BC during the pandemic. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines, the literature search was conducted using scientific databases starting from March 2020 through November 2021. Studies were identified and selected by two researchers based on inclusion criteria, and the relevant data were extracted and charted to summarize the findings. Ninety-three articles were included in this review. Main themes included are as follows: (i) the impact of COVID-19 on BC services; (ii) the impact of COVID-19 on health outcomes and well-being in women with BC; and (iii) any variation in the impact of COVID-19 on BC by social determinants of health. There were apparent disruptions to BC services across the cancer continuum, especially screening services. Clinical repercussions were a result of such disruptions, and women with BC experienced worsened quality of life and psychosocial well-being. Finally, there were social inequalities dependent on social determinants of health such as age, race, insurance status, and region. Due to the disruption of BC services during the COVID-19 pandemic, women were impacted on their health and overall well-being. The variation in impact demonstrates how health inequities have been exacerbated during the pandemic. This comprehensive review will inform timely health-care changes to minimize long-term impacts of the pandemic and improve evidence-based multidisciplinary needs.

Interruption of breast cancer care and importance of inter-hospital cooperation during the COVID-19 pandemic: A case report of advanced breast cancer in Fukushima, Japan

We experienced the case of a patient with advanced breast cancer who failed to receive comprehensive care despite regular video conferencing with her physician during the COVID-19 pandemic, resulting in delayed detection of liver metastasis. Inter-hospital collaboration is required to provide uninterrupted cancer care to those disproportionately affected by crises.