Phone follow-up (PFU) for breast cancer survivors (CS) during covid-19 pandemic: A single breast unit experience

ABSTRACT

Background: The COVID-19 outbreak became a public health emergency, leading to radical changes in care management. Hospitals are considered at risk for viral contamination and telemedicine allows CS to remain out of the hospitals. In our Institution all data concerning cancer patients are available through an Oncologic Web-based Electronic Medical Record (EMR) thus, the clinicians are able to access at any time CS medical history. From the start of COVID-19 pandemic we adopted EMR-assisted PFU instead of usual follow-up visit and this study aims to prospectively assess how breast CS perceived PFU. Method: We emailed to all breast CS managed by PFU a 15-item survey. Answers were measured with Likert scales. The correlation between CS characteristics and answers were analysed with Pearson test. Results: From February 2nd to May 20th, 107 out of 261 (41%) women fulfilled the survey. The median age was 61 (range 41-86), median follow up was 43 months (range 1-115). Most of the CS (67.3%) had high school diploma or higher degrees. About half of the CS were previously treated with adjuvant chemotherapy and 80% adjuvant endocrine therapy. 78.5% were able to reach the hospital autonomously. 66.4% suffered from COVID-19 related anxiety for their health and the majority (85%) were waiting for follow up visit to feel relief. 96.3% pts believed to have understood medical advice during PFU and were satisfied for the time and the opportunity to ask clarifications. 92% agreed with the decision to switch the usual followup visit in PFU. However, only 41.1% CS would like to have PFU in the future. We found a significant correlation between educational degree and comprehension during the visit (p=0.04) and with expectation for PFU feasibility (p=0.046). Age and educational level were significantly correlated with the ability to reach the hospital (p=0.046). CS treated with endocrine therapy were meaningfully correlated with the PFU satisfaction (p=0.048) Conclusions: PFU is an important tool to avoid hospital contacts during COVID-19 pandemic and the majority of CS who agree to participate in the survey agreed and felt satisfied from this procedure. The number of CS willing to have PFU in non-emergency situations invites to investigate the possibility to have routine PFU at least for a subset of the CS. Prospective randomized trials are warranted to assess the reliability of PFU compared to standard follow-up visit to implement telemedicine in daily clinical practice.