key: cord-1020170-xx6acmkh
authors: Barco, Israel; García-Fernández, Antonio; Menchen, Lidia; Giménez, Nuria; Fraile, Manel
title: Short term effects of an initial covid-19 Outbreak on Breast Cancer Care. A brief report
date: 2022-04-25
journal: Cir Esp (Engl Ed)
DOI: 10.1016/j.cireng.2022.04.009
sha: c391485ece83518bb8c4e226059bb0ae6ed42bdb
doc_id: 1020170
cord_uid: xx6acmkh

nan

A brief report. The pillars of Breast cancer (BC) care in Catalonia are a well established population screening programme (PSP), as well as an optimal performance of the Breast Units that harmonize the relative contribution from the involved departments. As of mid March 2020, covid pandemic was hitting hard on the catalan population (7.7 million), and a complete lockdown was decreed by the spanish government on March 14 (Figure1) 1 . At this stage, most public hospitals and primary care centres were being strongly devoted to covid-19 patient care in the region, while a great deal of the usual non-covid health assistance was being put on hold 2 . Thus, our PSP was halted from March 16,2020 to May 18, 2020. In the present investigation we aimed to ascertain the actual impact of such a deprived time on the care of patients with a new or recent diagnosis of BC, especially focusing on the initial diagnostic procedures, and surgery.

This study was restricted to two public university hospitals of Terrassa The ominous covid-19 pandemic is bound to have profound effects on many aspects of Health Care worldwide. Due to its high prevalence in the western world, BC is of much concern under the present circumstances 3 . Early BC diagnosis together with the improved women's awareness of the disease has led to a marked improvement of prognosis, with a present survival rate of 84% at 5 years 4 . In order to meet these goals, a well-built armamentarium has been deployed, including PSP, and an enhanced use of ultrasound scans (US), Magnetic Resonance Imaging (MRI), Core-needle biopsy, ever more conservative surgical procedures, improved radiation therapy, and updated systemic therapy. Much of such mindset and deployed resources seem at jeopardy during an initial covid-19 outbreak. Potential BC patients may refrain from consultation in the first place under the belief that hospitals are a source of infection 5 . The results from our investigation points to a drop of about 39% in overall BC care activity and about 42% in newly diagnosed cases. In general, the lack of significant differences between the study and control groups suggests that patients attending our hospitals during and shortly after the first outbreak did not have a more advanced disease stage, as perhaps one might have expected. A significant decrease of DCIS rate during the study period J o u r n a l P r e -p r o o f seems clearly related to the halting of our PSP for several weeks. More difficult to explain is the higher rate of a family history of BC among study patients.

Having first degree relatives with BC may have prompted them to seek medical care. Regarding BC patients actually being cared for, there seems not to have been any significant delay in diagnosis or treatment in the short term. However, more intriguing and perhaps worrying is the lack of information concerning those patients that went missing during the initial outbreak, lasting until late May (Figure1), who had not shown-up significantly by the end of September 2020, just prior to the second outbreak.

Financial disclosure: The authors have nothing to disclose.

The autors declare no conflicts of interest.

The present investigation was approved by the Clinical Investigation Ethical Review Board of both institutions (Hospital Mútua Terrassa and Hospital of Terrassa). 

Official statistics of

Incidència setmanal COVID-19 . Institut d'Estadísitca de Catalunya

Recommendations for triage, prioritization and treatment of breast cancer patients during the COVID-19

Implications of the COVID-19 pandemic for cancer in Spain

Analysis of cancer incidence, survival and mortality according to the main tumoral localizations

Suboptimal declines and delays in early breast cancer treatment after COVID-19 quarantine restrictions in China: A national survey of 8397 patients in the first quarter of 2020