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Background: Surgical resection remains the mainstay for early breast cancer. However, older patients with multiple co-morbidities may be deemed unsafe for general anaesthesia (GA). The Covid-19 pandemic necessitated some such surgery under local anaesthesia (LA) especially those who lacked anti-hormonal bridging therapy option. We present a retrospective study comparing outcomes following breast conserving surgery (BCS) under LA and GA. Method(s): 31 patients under LA (April 2018-March 2022) were compared with 31 age-matched patients under GA during the same period. Main outcomes were length of hospital stay and rates of margin positivity, re-operation, and post-operative complications within 1 month (including wound infections, seromas needing >=3 aspirations). Statistical analysis (with R-4.2.2) used two-tailed test with significant p-value (<0.05). Result(s): Only 5 LA cases were performed in the 2 years prior to first UK Covid-19 lockdown (March 2020), whilst 26 cases were performed in the 2 years after. [Formula presented] Conclusion(s): The number of BCS cases under LA increased five-fold following Covid-19 pandemic. Outcomes under LA were no worse than under GA. BCS under LA can allow BCS in patients unfit for or unwilling to have GA, especially older patients. Dedicated lists for BCS under LA may reduce need for resources such as hospital beds and overnight stays in the current resource and financially constrained health-care system.Copyright © 2023
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Objective: Identify changes in breast cancer detection method, stage at diagnosis and treatment prior to, during and after stay-at-home orders and restricted health care access due to COVID-19. Method(s): Statistical comparison of detection method (patient (PtD), mammography (MamD) or other), Anatomic TNM Stage 8 (0-IV) and invasive BC treatment change over time by three time periods (time 1: 2019+Q1 2020;time 2: Q2-Q4 2020;time 3: 2021) using chi-square analysis in an institutional retrospective cohort of first primary breast cancer (BC) patients (n=1799), years 20192021. Result(s): In the years prior to the study, 2016-2019, there was no difference in detection method or stage at diagnosis by year with 682 to 733 newly diagnosed BC annually (p=.462). In 2020 (n=535) and 2021 (n=582) annual diagnosed cases dropped 22% and 15% from 2019 levels. Compared to time 1, time 2 MamD BC dropped significantly (64% to 58%) with a subsequent increase in MamD BC to 70% in time 3 (p < .001) creating a U-shaped curve for MamD over time. PtD BC increased in time 2 from 30% to 36% but declined in time 3 to 25% (p <.001). Concurrently, stage at diagnosis shifted from time 1 to time 2 with stage 0 and I declining [stage 0: 21% to 16%, stage I: 40% to 38%] and stage II and IV increasing [stage II: 28% to 33%, stage IV: 2% to 4% stage IV] (p<.001). Subsequently in 2021 stage shifted again with an increase in stage 0 to 22% and stage I to 45% and a decline in stage II (33% to 24%), III (9% to 7%) and IV (4% to 2%) (p<.001). Combining stage 0 and I, the percentage of lower stage BC declined from 61% to 54% and increased to 67% in time 3 (2021) when health services became more readily accessible. There was no change in type of surgery for invasive breast cancer (stage I-III, n=1386) with equivalent numbers of breast conserving surgery (58%), subcutaneous mastectomy (24%) and mastectomy (18%) over the time period. Chemotherapy treatment rates for invasive BC did not change (38%). Radiation therapy increased from 66% (time 1: 2019+Q1 2020) to 73% (time 2: Q2Q4 2020) then back to 64% in time 3: 2021 (p=.007) independent of surgery type but concordant with an increase in stage IA and stage IIB BC among invasive breast cancer cases in time 2: Q2-Q4 2020 (p<.001). Likewise, neoadjuvant therapy increased and then declined from 33% to 38% to 29% from time 1 to time 3 (p<.001). Conclusion(s): Number of diagnosed BC cases fell after the first quarter of 2020 during the time of COVID-19 related shut downs and decreased access to health services. During the Q2-Q4 2020 time period mammography detected BC declined with a relative increase in patient detected breast cancer. When mammography detection declined, BC stage at diagnosis shifted to higher stage concurrent with increased rates of radiation and neoadjuvant therapy. In 2021, the relative increase in mammography detected BC indicates a return to more normal screening patterns with a catch up for screening lost in the prior year due to access limitations. In the third time period: 2021, with the return to prior levels of mammography detected breast cancer, stage shifted back to pre-pandemic expected distribution and the excess treatment with radiation and neoadjuvant therapy declined to previously observed levels. Although the changes in detection method, stage and treatment did not persist they were statistically significant and could represent a need for re-establishing prepandemic screening behavior. (Table Presented).
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Introduction: COVID 19 has huge impact on healthcare in General and challenges in Cancer services in particular. In breast Cancer prioritization strategies for management have been introduced at start of pandemic by different medical associations Aim: We aim to see impact of prioritization strategy in treatment of premenopausal and postmenopausal breast Cancer patient. This is further stratified as under 50, 50 to 70 and over 70. Method(s): A prospectively collected database from March 2020 to March 2021 analysed. This include patient demographic, tumour characteristics, Neoadjuvanct endocrine NAET), Neoadjuvanct chemotherapy (NACT), primary endocrine (PE), type of surgery: breast conservation Surgery (BCS) with or without oncoplastic procedure, Mastectomy with or without reconstruction and utilization of private sectors. Result(s): Total 454 patients reviewed. Mean age 61 yrs (26-97yrs). Total patient less than 50 years were 116. BCS 66 (57%), Simple mastectomy 26 (22%), Mastectomy with reconstruction 24 (20%).In this group 45 patients were of fered NACT and 6 patients had NAET. Total patients older than 50 years were 236. BCS 191 (80%), Simple mastectomy 38 (16%) and Mastectomy with reconstruction 7(3%) patients. In this group 69 patients had NACT and 13 had NAET. Patients over 70 years were 102. BCS 57(56%), Simple mastectomy 25(24%), 1 (1%) had mastectomy and reconstruction. 8 patients had NACT, 13 had NAET and 30 had primary endocrine. Conclusion(s): Due to swift guidelines in pandemic times breast Cancer services were largely intact and provide standard care.
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Purpose: To report final results of a clinical trial of APBI using intensity modulated radiotherapy (IMRT) to deliver 27 Gy in 5 daily fractions following breast conserving surgery (BCS) prospectively designed to assess the efficacy and cosmetic outcomes of a oneweek, APBI regimen among women with early breast cancer. Material(s) and Method(s): Women >= 50 years, with lymph nodenegative, ER positive, HER-2 negative breast cancer or ductal carcinoma in situ (DCIS), <= 3cm diameter, following BCS with margins >= 2mm, and excellent or good baseline cosmesis received 27 Gy in 5 daily fractions to the seroma plus 1 cm CTV and 0.7 cm PTV margins. Clinical photographs, patient and provider cosmetic scores, breast fibrosis, telangiectasia and pain were collected prospectively, prior to RT and at 6 weeks, 1 and 2 years after RT. The primary endpoint was the proportion of women who retained Excellent or Good cosmesis at 2 years using the EORTC Cosmetic Rating System. Cosmetic failure was deterioration from Excellent or Good to Fair or Poor. A panel of 5 radiation oncologists independently assessed the cosmetic photographs. Secondary endpoints were rates and grades of breast fibrosis, telangiectasia, breast pain, ipsilateral breast tumour recurrence (IBRT), overall (OS), breast cancer-specific survival (BCSS) and subsequent mastectomy. Efficacy outcomes were assessed at clinic visits and by review of charts. ClinicalTrials.gov registration: NCT02681107. Result(s): A total of 298 patients were treated between April 25, 2016, and October 31, 2019. At a median follow-up of 48 months, the four-year OS was 98.5% (95% CI 96.1% - 99.5%) and BCSS was 99.7% (95% CI 97.6% - 99.9%). The four-year IBRT rate was 3.3% (95% CI 1.1% - 6.4%). There were 10 contralateral breast events for a four-year rate of 3.9% (95% CI 2.2% - 6.9%). There were 10 ipsilateral and six contralateral mastectomies. Two patients died of unrelated causes prior to two years;79 patients declined inclinic attendance due to COVID or competing comorbidities and 217 women had two-year cosmetic photographs and clinical assessments performed. Consensus of the photo-panel cosmesis at baseline was: Excellent: n=116 (53%), Good: n=102 (47%), Fair: n=1 (0.5%) and Poor: n=0. Consensus overall cosmesis at two years was: Excellent: n= 141 (65%), Good: n=78 (35%), Fair: n=0 and Poor: n=0. Most patients had either improved (n=168;77%) or no change (n=43;20%) in cosmesis at two years. No patient had cosmetic failure but 6 (3%) had a change from Excellent to Good at two years. Most patients reported either no (79%) or mild (21%) pain, with no moderate or severe pain. Two patients (0.9%) had Grade 2 fibrosis and five patients (2%) had visible telangiectasia that did not detract from overall cosmesis. Conclusion(s): APBI using 27 Gy in 5 fractions using a conformal IMRT technique, achieved excellent two-year cosmesis with minimal toxicity. The IBRT risk was comparable to the contralateral new breast cancer risk and to local recurrence rates of recently published early breast cancer trials. Copyright © 2022 Elsevier Ireland Ltd. This is an open access article under the CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Purpose: Breast-conserving surgery followed by several weeks of adjuvant radiotherapy is the current standard of care for low-risk breast cancer. A novel approach using single-fraction neoadjuvant radiotherapy is under study. We sought to investigate the rate of pathologic response, toxicities and cosmetic results related to this new treatment strategy. Material(s) and Method(s): Women 65 years of age or older with a new diagnosis of Stage I unifocal luminal A breast cancer were eligible for inclusion in this Phase I prospective trial. A single 20 Gy dose of radiotherapy to the breast tumour was given, followed by breast-conserving surgery three months later. The primary endpoint was the pathologic response rate assessed by microscopic evaluation using the Miller-Payne system. The secondary endpoints were the incidence of radiation toxicity and the cosmetic results, graded according to the Common Terminology Criteria for Adverse Events and the European Organisation for Research and Treatment of Cancer Cosmetic Rating System, respectively. Secondary outcomes were assessed at 6 weeks, 4 months and yearly after radiotherapy. Result(s): To date, 13 patients have been successfully treated with a median age of 71 years (range: 65-83 years). As previously reported, neoadjuvant radiotherapy resulted in a tumour pathologic response in 11 of 13 patients with a median residual cellularity of 1% (range: 0-10%). With an average follow-up of 31.9 months (range: 24.4- 39.2 months), no disease recurrences or deaths were recorded. Acute radiation toxicities were limited to Grade 1 dermatitis and breast pain. At the one-year follow-up, 11 patients had Grade 1 toxicities (dermatitis, fibrosis, breast pain and chest wall pain), one patient had a Grade 2 fatty necrosis, and two patients had Grade 3 toxicities (wound infection and hematoma). Only Grade 1 toxicities remained at the two-year follow-up. One-year cosmetic results were good or excellent in 46% of patients according to their self-assessment and in 54% of them according to the nurse's evaluation. Two-year cosmetic results were unavailable due to in-person visits cancellations during the COVID-19 pandemic. Conclusion(s): This study demonstrates that a single fraction of neoadjuvant radiotherapy preceding breast-conserving surgery is feasible, relatively well tolerated and leads to a high level of pathologic response for most patients. The Grade 3 toxicities and underwhelming cosmetic results may indicate that the 3-month interval after radiotherapy places surgery in a post-radiation inflammatory phase. Larger trials are needed to better assess the long-term toxicities as well as the optimal timing and fractionation of this novel technique in the management of early-stage breast cancer. Copyright © 2022 Elsevier Ireland Ltd. This is an open access article under the CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Background: The Coronavirus Disease 2019 (COVID-19) pandemic has changed the delivery of cancer care and may have impacted the treatment outcomes. This study described the preliminary outcomes in non-metastatic breast cancer (BC) patients before and during the COVID-19 pandemic. Methods: This retrospective study included adult patients newly diagnosed with non-metastatic BC at two community cancer centers in southeast Texas. Patients diagnosed from 1/2018-10/2018 were included in the control group. Patients diagnosed from 4/2020-1/2021 were included in the COVID-19 group. The key outcomes were progression free survival (PFS), overall survival (OS), breast conserving surgery (BCS) rate, pathological complete response (PCR) rate, and time to treatment initiation (TTI). Results: The study included 74 patients (Table). The proportion of patients with self-detected BC was numerically higher in the COVID-19 group (55%) compared to the control group (36%), although this was not statistically significant (P = 0.09). The median follow-up periods were 38 (IQR: 36-43) months in the control group and 15 (IQR: 13-17) months in the COVID-19 group. No significant difference was observed in PFS (P = 0.74), with 1-year PFS of 93% (95%CI: 80%-98%) in the control group and 100% in the COVID-19 group. No significant difference was observed in OS (p = 0.22), with 1-year OS of 98% (95%CI 85%-100%) in the control group and 100% in the COVID-19 group. No significant difference was observed in TTI between control (51 days) and COVID-19 groups (52 days) (95%CI: -14 to 13;P = 0.91). Among patients who received neoadjuvant systemic therapy and surgery, BCS rates were 29% (5/17) in the control group and 50% (5/10) in the COVID-19 group (P = 0.42). Among patients who had triple negative or HER2 positive BC and received neoadjuvant systemic therapy and surgery, PCR rates were 57% (4/7) in the control group and 33% (1/3) in the COVID-19 group. Conclusions: Although total patient volume decreased during the COVID-19 pandemic, no significant difference was observed in clinical outcomes when comparing patients diagnosed with non-metastatic BC during and prior to the pandemic. Ongoing monitoring with a larger study population and longer followup period will help to elucidate the long-term impact of COVID-19 on BC treatment.
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Aim: National reported mastectomy rate varies from 25% - 45%. Improved screening and raised breast awareness raise the demand for breast cancer treatment. 25% - 45% of breast cancer treatment will be mastectomies, some of them followed by reconstruction. Mastectomy +/-reconstruction is a traumatic procedure which affects quality of life of patients plus extra cost for NHS for reconstruction. We would like to investigate if the technique of local perforator flaps can reduce the volume of mastectomies. Method: Retrospective review of yearly breast cancer treatment operations from 2016 to 2020 in Ipswich Hospital. Results: 1367 surgical operations performed for breast cancer.In 2016,52/273(19%) patients had mastectomy and 8/273(2.9%) underwent a perforator flap operation. In 2017, 85/292 (29,1%) had mastectomy and 13/292 (4,4%) had local perforator flap surgery. In 2018, the number of mastectomies was 74/299 (24.7%), while 4/299 (1.3%) patients underwent local perforator flap surgery. In 2019, the amount of perforator flaps increased to 24/305(7.8%) while the mastectomies remained in equivalent percentages [72/305 (23.6%)]. Finally, in 2020, despite the presence of COVID19 and the decrease in surgical management of cancer, 16/198(8.5%) had local perforator flaps surgery and only 34/198 (18%) had mastectomy.0/57 (0,00%) of the local perforator flaps failed. Conclusions: Local perforator flaps have resulted in 11.1% reduction in mastectomy rate (also reducing reconstructions). The exchange of mastectomy and reconstruction with breast conserving surgery and local perforator flap reduces the operating time and cost of cancer treatment without compromising oncological outcome or patient satisfaction.
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Background: The Covid Pandemic has influenced how cancer surgeries are performed and their pre-operative management to allow appropriate social distancing and self-isolation prior to Surgery. With the requirement of wire localisation of non-palpable breast cancers/ lesions on the day of surgery and non-availability of mammogram and ultrasound machine in an isolated zone, we embarked on localisation of non-palpable breast lesions using MagseedR markers and SentimagR localisation system. We describe our initial experience in the management of these cancers and diagnostic excision biopsies using Magseed. Materials and Methods: Forty consecutive female patients, median age 61 (range 36-84) years underwent Magseed insertion for diagnostic excision biopsy (n=4) and breast conservation surgery (WLE;n= 36). Check mammograms were performed following Magseed insertion to confirm appropriate localisation. During the initial audit of 16 patients, one Magseed guided WLE and sentinel node biopsy was abandoned due to erratic signal strength on the day of surgery and underwent surgery with wire localisation on a later date. Subsequently all cases had Magseed signals confirmed following insertion in the radiology department along with check mammograms. Results: Thirty-nine patients underwent successful breast surgery (Magseed in intra-operative specimen X-ray) with standard axillary procedures (29 sentinel node biopsy, 2 axillary node clearance). The median time from magseed insertion to surgery was 13 (range 3-38) days. The lesions were invasive neoplasm +/- insitu (DCIS) disease (n= 32), DCIS (n=5), and papilloma (n=3). The median overall tumour size was 20 (range 3-38) mm and on postop histology was 17 (2-50) mm. Six patients required further re-excision for margin positivity with DCIS;margins were clear after single cavity shave(n=4) and two patients underwent mastectomy subsequently. Conclusions: Magseed localisation have given us significant flexibility in the management of non-palpable breast cancer and indeterminate lesions requiring diagnostic biopsy during the Covid pandemic. Initial audit suggests usefulness of confirming adequate Magseed signal in the radiology department along with check mammogram during the early learning curve.
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Background: From September 2018 to June 30 2021 1358 immediate reconstructive procedures were performed by a single reconstructive surgeon in a multi-disciplinary unit. 2000 breast cancer patients were seen over this time This data tracks the types of procedures done and the changes in the procedures including over the time of the SARS COVID19 pandemic. Mastectomies were skin and nipple-sparing (SSM) with implant or autologous reconstruction. Breast-conserving surgery (BCT)had a variety of oncoplastic techniques performed from therapeutic mammoplasties (TM) with opposite side matchings (OSM) and parenchymal flaps (PF) with no OSM. A subset of the BCT had intra-operative radiation therapy. Intra-operative pathology is available for all cases as well as Biovision radiology in theatre. Materials and Methods: Full analysis of the data set was performed on a per-procedure basis, the data set strictly excluded any patient with an incomplete dataset or categorization outside of the study directive to avoid any possible inflation. The data was divided into 2 groups.SSM and immediate reconstruction (either direct to implant(DTI)) or goldilocks mastectomy (GM)and thoraco-epigastric flap (TE)reconstruction or breast-conserving surgery (BCT) with reconstruction. Timelines of what procedures were done each year and the differences per year were analysed Results: For the period of 2018 and 2019, one hundred and three bilateral SSM DTI procedures were performed with six Unilateral SSM and DTI and for the same period ninety-one GM with TE reconstructions For the period of 2020, sixty-one Bilateral DTI and 3 unilateral DTI were performed with twenty-two GM;TE For the first half of 2021 forty bilateral SSM and DTI and, a single unilateral SSM DTI was performed with eight GM;TE Over the same three year period a total of 205 Parenchymal Flap procedures and 559 therapeutic mammoplasties (TM) There was a 99.8% immediate reconstructive rate with no loss of prosthesis over the entire period Conclusions: Whilst the 2020 COVID19 pandemic had a large influence on hospital conditions (restriction of surgical time and bed availability);adaptations within the unit allowed for reconstructive procedures to be offered to all eligible patients, offering every patient immediate reconstruction based on patient-, oncological factors and patient’s preference.
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Day surgery breast-conserving surgery (DS-BCS) is a surgical approach applied in many specialized breast surgery departments. This study demonstrates the benefits of this approach from the perspectives of patients and of the Hospital/National Health System compared to ordinary breast-conserving surgery (ORD-BCS) under general anesthetic. A comparison of costs and diagnosis-related group (DRG) reimbursement demonstrated improved cost-effectiveness in DS-BCS compared to ORD-BCS.
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The current pandemic due to the new Coronavirus (SARS-CoV-2) requires the health systems to rapidly adopt measures aimed at mitigating the crisis, which implies redistributing economic and social resources and the workforce, so that those sectors of the population most affected can be cared for in an optimal and timely manner. In patients with low-risk invasive breast cancer and low-risk ductal carcinoma in situ, postoperative radiation therapy does not offer any benefit in overall survival, making the idea of omitting this oncological resource attractive. In this second article, we conducted a review of the literature on the criteria for omitting adjuvant radiotherapy in patients with low-risk breast neoplasms. In addition, the recommendations issued during the current contingency made by some international scientific societies are summarized, and certain reasons why physicians refuse to change clinical behaviors that offer limited advantages are analyzed, many times outweighed by the associated risks and adverse effects. © 2021
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Aims: Improved screening and raised breast awareness raises the demand for breast cancer treatment. 25% - 45% of breast cancer treatment will be mastectomies, some of them followed by reconstruction. Mastectomy +/-reconstruction is a traumatic procedure which affects quality of life of patients plus extra cost for NHS for reconstruction. Can the “relative new” technique of local perforator flaps, reduce the volume of mastectomies (and subsequently reconstructions) in a District General Hospital? Methods: Retrospective review of yearly breast cancer treatment operations from 2017 to 2020 in Ipswich Hospital. Results: 1094 surgical operations performed for breast cancer. In 2017, 85/292 (29,1%) had mastectomy and 13/292 (4,4%) had local perforator flap surgery. In 2018, the number of mastectomies was 74/299 (24.7%), while 4/299 (1.3%) patients underwent local perforator flap surgery. In 2019, the amount of perforator flaps increased to 24/305(7.8%) while the mastectomies remained in equivalent percentages [72/305 (23.6%)]. Finally, in 2020, despite the presence of COVID19 and the decrease in surgical management of cancer, 16/198(8.5%) had local perforator flaps surgery and only 34/198 (18%) had mastectomy.0/57 (0,00%) of the local perforator flaps failed. Conclusions: Local perforator flaps have resulted in 11.1% reduction in mastectomy rate (also reducing reconstructions). The exchange of mastectomy and reconstruction with breast conserving surgery and local perforator flap reduces the operating time and cost of cancer treatment without compromising oncological outcome or patient satisfaction.
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Purpose: The purpose of this study was to examine the effect of COVID-19 infection on the morbidity and mortality rates of breast cancer patients performed in the East Mediterranean region of Turkey during the COVID-19 pandemic and to share the results of those investigations. Methods: This retrospective study included all breast cancer patients that underwent surgery during the COVID-19 pandemic in the General Surgery Clinic of Adana City Training and Research Hospital, a regional pandemic hospital, between March 11, 2020 and December 25, 2020. The patients were evaluated preoperatively and postoperatively (the first 30 days) in terms of COVID-19 infection. Moreover, these patients were also evaluated in terms of admission to the hospital, length of hospital stay, and mortality due to COVID-19 infection during the follow-up period of the study. Results: Included in the study were 139 patients that underwent surgery for breast cancer during the pandemic period, with no observed mortality or morbidity associated with COVID-19 in any patient postoperatively within the first 30 days. In addition, within 121.22±70.05 days, the mean and standard deviation of the study's follow-up period, 19 patients (15.7%) were admitted to the hospital with a suspected COVID-19 infection (after the first 30 days postoperatively) and 6 of them (4.3%) returned a positive PCR test. All of the COVID-19 positive patients (6 patients, 4.3%) were hospitalised and 3 of them (2.2%) died due to the COVID-19 infection. Conclusions: Breast cancer surgery can be performed safely during the COVID-19 pandemic period after taking the necessary precautions.
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Aim: Wire guided localisation(WGL) to localise non-palpable breast tumours has been the standard for years. WGL has limitations;patient discomfort, fixed scheduling to facilitate insertion on the day of surgery and wire migration. A 2015 audit in our department found that 51% of patients undergoing wide local excision (WLE) used preoperative localisation techniques;of which 84% was WGL. The overall re-excision rate for WLE was 27%. We altered our practice to Magseed localisation from July 2019 to improve patient experience, and surgical efficiency, as there are similar outcomes between WGL and Magseed in the literature. This audit aims to examine if there are improvements in our re-excision rate. We aim to evaluate which is the best method for localisation in our department. Method: A retrospective audit was conducted following registration with the local audit office. Patients who underwent breast conserving surgery between September 2019 and September 2020 were identified. The surgical approach, re-excision and complications were recorded and compared to the 2015 results. Results: 100 patients underwent WLE in the study period. The percentage of patients undergoing therapeutic mammaplasty was 26% (14% in 2015). 63% underwent preoperative localisation;of which 71% used Magseed and 5% used wire. The overall re-excision rate was 20%. Conclusions: Our re-audit has demonstrated an increase in patients requiring pre-operative localisation, probably due to the use of primary endocrine treatment during COVID-19. We gladly observed 26% improvement in re-excision rates suggesting success with Magseed.
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The recent COVID-19 pandemic has caused profound changes to healthcare systems as well as had deleterious repercussions on the care of cancer patients. In this comparative study, we sought to evaluate the effects of the COVID-19 pandemic on the surgical management of breast cancer in a breast unit in an Italian region with a low incidence of COVID-19 infection. Eighty-three patients were included, of whom 41 received surgery during the height of the pandemic (Group A, operated on between March and April 2020), and 42 during the same period of the year in 2019 (Group B). Clinicopathological characteristics and surgical outcomes were compared between the two groups. There were no significant differences in the baseline characteristics of the two groups with regard to age (p = 0.62), tumour size (p = 0.25), grade (p = 0.27), histology (p = 0.43), positive lymph node status (p = 0.35), and ER positive status (0.35). Waiting time for surgery was slightly longer in Group A (49.11 vs. 46.39 days, p = 0.38). Patients receiving immediate breast reconstruction were significantly less in Group A (p < 0.001). The use of sentinel node biopsy was similar in the two groups (p = 0.84). Hospital stay was longer in patients of Group B (p = 0.008). The use of regional nerve blocks was lower in Group A (p < 0.001). Patients operated on during the height of the pandemic were less likely to receive immediate reconstruction and regional nerve blocks during surgery. These features configure a situation of reduced level of care for patients with breast cancer. Efforts should be taken by the healthcare systems to maintain standard of care, even in case of a new peak in the coronavirus outbreak.