Effects of COVID-19 pandemic in a breast unit: Is it possible to avoid delays in surgical treatment?

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic has caused fear all around the world. With people avoiding hospitals, there has been a significant decrease in outpatient clinics. In this study, we aimed to compare and explore the first peak of the pandemic period by studying its effects on patient applications, new diagnoses and treatment approaches in a non-infected hospital. METHODS: We collected data from the first peak of the pandemic period in Turkey, from the pandemic declaration (11 March 2020) to social normalization (1 June 2020), and compared it with the data from a pre-pandemic period with a similar length of time. We analyzed the data of breast cancer patients from application to surgery. RESULTS: The data of 34 577 patients were analyzed for this study. The number of patients who applied to outpatient clinics decreased significantly during the pandemic period. After excluding control patients and benign disorders, a figure was reached for the number of patients who had a new diagnosis of breast cancer (146 vs. 250), were referred to neoadjuvant treatment (18 vs. 34), and were treated with surgery (121 vs. 229). All numbers decreased during the pandemic period, except for surgeries after neoadjuvant treatment (21 vs. 25). Surgical treatment approaches also changed. However, the rate of newly diagnosed breast cancer patients treated with surgery was similar in both periods. None of these patients were diagnosed with COVID-19 or died during the pandemic. CONCLUSION: This study shows that non-infected hospitals can be useful in avoiding delays in the surgical treatment of cancer patients.

Breast cancer metastasis into thyroid papillary carcinoma: A case report.

Both metastatic tumors and breast cancer metastases in the thyroid gland are rare. Tumor metastasis into a primary thyroid cancer is rarer. We present a case with breast cancer metastasis into a metachronous thyroid papillary carcinoma which is the only case in literature.

Did the COVID-19 Pandemic Cause a Delay in the Diagnosis of Acute Appendicitis?

BACKGROUND: Appendectomy for acute appendicitis remains one of the most common surgical procedures. This study aims to assess the clinical presentation and delays in diagnosing acute appendicitis during the COVID-19 pandemic. METHODS: We evaluated data of all adult patients who underwent an appendectomy at our hospital between June 1, 2019 and June 1, 2020. Demographic data, admission type to the emergency room, radiological findings, pathological findings, and hospitalization time were noted. Patients were divided into four groups of 3-month periods, pre (Groups 5, 4, 3, 2) and during the pandemic (Group 1). Hospitalization time and perforation status of each group were compared. The hospital admission type and their effect on perforation were also evaluated. RESULTS: Two hundred and fourteen patients were included; 135 patients were male, and 57 were female. The median age was 39 years. In Group 1 (pandemic period), 28.8% of patients were referred to us from pandemic hospitals. The median hospitalization time was 7.3 h before pandemics (Group 2-5), 5 h in the pandemic period (Group 1). Perforation rates were 27.8% in Group 1, 23.3% in Group 2, 16.3% in Group 3, 14.0% in Group 4, and 18.6% in Group 5 (0 = 0.58). There was no difference in the patients in Group 1 in the rate of perforated appendicitis in patients who were referred from other pandemic hospitals (29.4) and those admitted via our own emergency room (16.6%) (p = 0.27) during the pandemic period. CONCLUSION: We did not observe any clear increase in the diagnosis of perforated appendicitis during the pandemic period, even in patients who were transferred from other hospitals.

The evaluation of contralateral breast lesions in breast cancer patients using reduction mammoplasty.

PURPOSE: This study evaluated the importance of routine pathological examination of contralateral breast specimens in breast cancer patients using reduction mammoplasty. METHODS: The weight of breast tissue resected from the contralateral breast in 71 patients and the number of slices used for pathological evaluation were recorded. Breast lesions found in the contralateral breast and accompanying lesions with tumors were examined. RESULTS: High risk proliferative lesions were reported in the contralateral breast of eight (11.2%) patients, and low-risk lesions were detected in 18 (25%). While the mean age of the patients with high-risk lesions was 45.6, it was 52.8 for the other patients (p=0.036). CONCLUSION: Bilateral reduction mammoplasty may be beneficial to delineate some pathologies in contralateral breasts even in those patients with normal clinical and radiological findings. The incidental discovery of these pathologies is much more likely in young breast cancer patients.