THE IMPACT OF THE COVID-19 PANDEMIC IN THE CLINICAL ASSISTANCE TO BREAST CANCER PATIENTS.

Abstract

ABSTRACT INTRODUCTION: The COVID-19 pandemic led to important health care access limitations. We aimed to disclose the impact of the pandemic on breast cancer patients in a specialized Breast Cancer Center (BCC). PATIENTS AND METHODS: A total of 501 breast cancer patients with a first appointment in the BCC from April 1st,2019 to March 31st, 2021 were divided into 4 consecutive periods of 6 months. Data from the homologous semesters was compared. Patients with an appointment in the BCC during the study period were eligible for the secondary aim of our study (BCC workload). RESULTS: After the pandemic declaration (period 3), we found a decrease in the referral by screening programs (p=0.002) and a reduction in the waiting time between the Primary Care (PC) referral and the first BCC appointment (p<0.001). There were higher rates of palpable axillary nodes (p=0.001), an increase in N stage 2 and 3 (p=0.050), and a trend for primary endocrine therapy as the first treatment (p=0.021) associated with higher rates of complete axillary node dissection (p=0.030). In period 4, there were more outward diagnoses (p=0.003), a higher rate of surgery as the first treatment (p=0.013) and fewer days between the PC referral and first BCC appointment (p=0.009). No differences were found in the number of patients received and treated in the BCC during the four periods. In period 4, the waiting time for surgery was lower (p=0.002). CONCLUSIONS: COVID-19 pandemic implied a more advanced nodal stage, which may be related to the delay in breast cancer screening.