Changes in the operative management of breast cancer during the COVID pandemic-single institution experience

ABSTRACT

Aims: COVID has had a wide ranging impact on surgical practice;including staffing issues, procedural prioritisation and changes to perioperative practice. We aim to compare The operative management of breast Cancer before and during year 1 of The pandemic. Method(s) A retrospective review of primary breast Cancer Surgery in women between 23/3/2020-23/3/2021 with sub-analysis looking at wave 1 of COVID (23/3/2020-23/7/2020), compared to pre-COVID (1/1/2018-31/12/2018). Data collected include type and complexity of surgery, re-operations and complications. Result(s) Pre-COVID, 606 cancers were included, with 217 (35.8%) Simple BCS, 241(39.8%) oncoplastic BCS, 88 (14.5%) Simple mastectomies and 60 (9.9%) mastectomies with immediate reconstruction. During COVID study period, a total of 398 cancers were included, with operative number (percentages) being 104(26.1%), 176(44.2%), 83(20.9%) and 35(8.8%) respectively. During wave 1, 47 cancers were diagnosed and operated on. The operative numbers (percentages) during initial wave COVID pandemic were 9 (19.1%), 25(53.2%), 12(25.5%) and 1(2.1%) respectively. Conclusion(s) In our unit COVID led to a shift of breast Cancer operative management to more BCS and Simple mastectomies. As a unit, we were able to maintain good oncoplastic BCS service, however, reconstruction options were limited.