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Time to Treatment Initiation for Breast Cancer During the 2020 COVID-19 Pandemic.
Hawrot, Kathryn; Shulman, Lawrence N; Bleiweiss, Ira J; Wilkie, Elizabeth J; Frosch, Zachary A K; Jankowitz, Rachel C; Laughlin, Amy I.
  • Hawrot K; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Shulman LN; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Bleiweiss IJ; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Wilkie EJ; Penn Cancer Network, Philadelphia, PA.
  • Frosch ZAK; Division of Hematology and Oncology, Perelman School of Medicine, Philadelphia, PA.
  • Jankowitz RC; Penn Center for Cancer Care Innovation, Abramson Cancer Center, Philadelphia, PA.
  • Laughlin AI; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
JCO Oncol Pract ; 17(9): 534-540, 2021 09.
Article in English | MEDLINE | ID: covidwho-1133634
ABSTRACT

PURPOSE:

The COVID-19 pandemic has posed significant pressures on healthcare systems, raising concern that related care delays will result in excess cancer-related deaths. Because data regarding the impact on patients with breast cancer are urgently needed, we aimed to provide a preliminary estimate of the impact of COVID-19 on time to treatment initiation (TTI) for patients newly diagnosed with breast cancer cared for at a large academic center.

METHODS:

We conducted a retrospective study of patients with newly diagnosed early-stage breast cancer between January 1, 2020, and May 15, 2020, a time period during which care was affected by COVID-19, and an unaffected cohort diagnosed between January 1, 2018 and May 15, 2018. Outcomes included patient volume, TTI, and initial treatment modality. Adjusted TTI was compared using multivariable linear regression.

RESULTS:

Three hundred sixty-six patients were included. There was an 18.8% decrease in patient volume in 2020 (n = 164) versus 2018 (n = 202). There was no association between time of diagnosis (pre-COVID-19 or during COVID-19) and adjusted TTI (P = .926). There were fewer in situ diagnoses in the 2020 cohort (P = .040). There was increased use of preoperative systemic therapy in 2020 (43.9% overall, 20.7% chemotherapy, and 23.2% hormonal therapy) versus 2018 (16.4% overall, 12.4% chemotherapy, and 4.0% hormonal therapy) (P < .001).

CONCLUSION:

TTI was maintained among patients diagnosed and treated for breast cancer during the COVID-19 pandemic at a single large academic center. There was a decrease in patient volume, specifically in patients with in situ disease and a shift in initial therapy toward the use of preoperative hormonal therapy.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Breast Neoplasms / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans Language: English Journal: JCO Oncol Pract Year: 2021 Document Type: Article Affiliation country: OP.20.00807

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Breast Neoplasms / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans Language: English Journal: JCO Oncol Pract Year: 2021 Document Type: Article Affiliation country: OP.20.00807