The Impact of the COVID-19 Pandemic on the Diagnosis and Treatment of Breast Cancer at a Community Hospital.

IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2025-02-14 DOI:10.1016/j.clbc.2025.02.005

Mariah Mack, Matthew McGee, Barbara Bennie, Andrea Arenz, Leah Dietrich

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引用次数: 0

Abstract

Background: The COVID-19 pandemic disrupted breast cancer care, potentially affecting diagnosis stage, time to treatment initiation, and treatment modalities. This study evaluated how pandemic-related restrictions affected these factors at a community hospital.

Methods: We conducted a retrospective review of electronic health records for 941 patients diagnosed with breast cancer. Patients were categorized by diagnosis time. We used Kruskal-Wallis tests to compare median time to first treatment by modality, COX proportional hazard models to analyze time to treatment in relation to diagnosis time period and clinical stage, and Chi-square tests to evaluate changes in modality of first treatment and cancer stage.

Results: Clinical stage at diagnosis varied significantly across time periods (P = .01), with more advanced stages during Peak-COVID and Post-Peak-COVID. Median time to first treatment increased during Peak-COVID (47 days) and Post-Peak-COVID (54 days) compared to Pre-COVID (38 days) (P < .001). Time to surgery as first treatment modality increased over the 3 periods (P < .001), while no significant differences were found for chemotherapy (P = .06) or hormone therapy (P = .28). The modality of first treatment shifted significantly (P < .001), with a decline in hormone therapy use during Peak-COVID, followed by an increase Post-Peak-COVID.

Conclusions: Our study highlights the pandemic's impact on breast cancer care, demonstrating significant differences in clinical stage at diagnosis, time to first treatment, and modality of first treatment. These disparities persisted into 2022, reflecting lasting effects of pandemic-related disruptions. Addressing these delays is essential for mitigating care gaps in future times of healthcare disruption.

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新冠肺炎疫情对社区医院乳腺癌诊疗的影响

背景：2019冠状病毒病大流行扰乱了乳腺癌护理，可能影响诊断阶段、开始治疗的时间和治疗方式。本研究评估了社区医院与大流行相关的限制措施如何影响这些因素。方法：我们对941例乳腺癌患者的电子健康记录进行了回顾性分析。根据诊断时间对患者进行分类。采用Kruskal-Wallis检验比较不同治疗方式到首次治疗的中位时间，采用COX比例风险模型分析治疗时间与诊断时间和临床分期的关系，采用卡方检验评价首次治疗方式和癌症分期的变化。结果：不同时期诊断时的临床分期差异显著（P = 0.01），在冠状病毒感染高峰和冠状病毒感染后阶段更晚期。与covid前（38天）相比，高峰期间（47天）和高峰后（54天）至首次治疗的中位时间增加（P < 0.001）。手术作为第一种治疗方式的时间在3个时期内增加（P < 0.001），而化疗（P = 0.06）或激素治疗（P = 0.28）无显著差异。首次治疗的方式发生了显著变化（P < 0.001），在高峰期间激素治疗的使用减少，随后在高峰后增加。结论：我们的研究强调了大流行对乳腺癌护理的影响，显示了诊断临床阶段、首次治疗时间和首次治疗方式的显著差异。这些差异一直持续到2022年，反映了与大流行有关的中断的持久影响。解决这些延误问题对于缓解未来医疗保健中断时期的医疗缺口至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.