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Breast Cancer Screening, Diagnosis, and Surgery during the Pre- and Peri-pandemic: Experience of Patients in a Statewide Health Information Exchange.
Milgrom, Zheng Z; Milgrom, Daniel P; Han, Yan; Hui, Siu L; Haggstrom, David A; Fisher, Carla S; Mendonca, Eneida A.
  • Milgrom ZZ; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA. omilgrom@iu.edu.
  • Milgrom DP; Providence Saint John's Cancer Institute, Santa Monica, CA, USA.
  • Han Y; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Hui SL; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Haggstrom DA; Regenstrief Institute, Indianapolis, IN, USA.
  • Fisher CS; Regenstrief Institute, Indianapolis, IN, USA.
  • Mendonca EA; Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
Ann Surg Oncol ; 30(5): 2883-2894, 2023 May.
Article in English | MEDLINE | ID: covidwho-2233302
ABSTRACT

BACKGROUND:

Measures taken to address the COVID-19 pandemic interrupted routine diagnosis and care for breast cancer. The aim of this study was to characterize the effects of the pandemic on breast cancer care in a statewide cohort. PATIENTS AND

METHODS:

Using data from a large health information exchange, we retrospectively analyzed the timing of breast cancer screening, and identified a cohort of newly diagnosed patients with any stage of breast cancer to further access the information available about their surgical treatments. We compared data for four subgroups pre-lockdown (preLD) 25 March to 16 June 2019; lockdown (LD) 23 March to 3 May 2020; reopening (RO) 4 May to 14 June 2020; and post-lockdown (postLD) 22 March to 13 June 2021.

RESULTS:

During LD and RO, screening mammograms in the cohort decreased by 96.3% and 36.2%, respectively. The overall breast cancer diagnosis and surgery volumes decreased up to 38.7%, and the median time to surgery was prolonged from 1.5 months to 2.4 for LD and 1.8 months for RO. Interestingly, higher mean DCIS diagnosis (5.0 per week vs. 3.1 per week, p < 0.05) and surgery volume (14.8 vs. 10.5, p < 0.05) were found for postLD compared with preLD, while median time to surgery was shorter (1.2 months vs. 1.5 months, p < 0.0001). However, the postLD average weekly screening and diagnostic mammogram did not fully recover to preLD levels (2055.3 vs. 2326.2, p < 0.05; 574.2 vs. 624.1, p < 0.05).

CONCLUSIONS:

Breast cancer diagnosis and treatment patterns were interrupted during the lockdown and still altered 1 year after. Screening in primary care should be expanded to mitigate possible longer-term effects of these interruptions.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Breast Neoplasms / Health Information Exchange / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans Language: English Journal: Ann Surg Oncol Journal subject: Neoplasms Year: 2023 Document Type: Article Affiliation country: S10434-023-13119-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Breast Neoplasms / Health Information Exchange / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans Language: English Journal: Ann Surg Oncol Journal subject: Neoplasms Year: 2023 Document Type: Article Affiliation country: S10434-023-13119-w