ABSTRACT
Aim: Behavioral changes in seeking medical attention during COVID- 19 pandemic and its impact on breast cancer outcomes has never been studied. Methods: This is a case-control study comparing breast cancer patients treated between Quarter 1 2020 (Case, COVID-19 pandemic) and Quarter 1 2019 (Control). Clinical and pathological data between the two groups were compared. Patients from the case group were interviewed using a standardized questionnaire. Results: There were 57 patients in the case group and 101 patients in the control group. Mean ages of diagnosis were 56.1 (Range 34-75) and 57.4 (Range 30-84) years old respectively. Mean duration of symptom prior to the first specialist consultation in the case group was 6.4 weeks (2-32 weeks) while that in the control group was 3.1 weeks. 12/57 (21.1%) patients had delayed presentation for their breast symptoms during COVID-19 outbreak. The mean score of anxiety on hospital acquired COVID-19 infection was 3.3 out of 5 (Range 1-5) There were significantly less DCIS in the case group (N = 5 vs 32, 8.8% vs 31.7%) (P = .0009). However, there were more T2 or above cancers in the case group (N = 32 vs 28, 56.1% vs 27.7%) (P = .0008). N stage was not significantly different between the two groups. Mean surgery waiting time were similar (2.6 and 2.5 weeks respectively). Mastectomy rate was lower in the case group (42% vs 75.4%). There was no difference in reconstruction rate (19.2% vs 16.8%). Conclusions: Breast cancer patients tends to present late during COVID-19 pandemic.