在一个多民族的亚洲中等收入国家,COVID-19对乳腺癌管理的影响

Ng Jing Hui, See Mee Hoong, Tneoh Jia Min, Teh Mei Sze, Mahmoud Danaee, Nur Shahirah Abdul Latiff, Abigail Ashwini Murali, Lee Lee Lai
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引用次数: 1

摘要

目的:2019冠状病毒病(COVID-19)导致医院暂停常规手术。随着世界经济的复苏,人们担心许多疾病的后果已受到损害。本研究旨在评估大流行对马来西亚吉隆坡一家教学医院乳腺癌人口统计学、临床病理特征和患者管理的影响。材料和方法:收集2019年1月1日至2020年3月18日期间的covid - 19前数据,当时实施了全国封锁,导致马来亚大学医学中心(UMMC)乳房诊所暂停服务。COVID数据从2020年3月至2021年6月获得。结果:本研究将374例处于COVID-19期的乳腺癌患者与382例处于COVID-19前期的乳腺癌患者进行了比较。术前[45(26.50-153.50)天]与新冠[44(24.75-156.25)天]至手术的中位时间(范围)无显著差异。乳腺癌的临床病理特征表现为在COVID期间原位癌的减少和4期诊断的增加。在COVID期间,筛查发现的癌(9%对12.3%)、乳房切除术后立即重建(5.6%对14.5%)和辅助化疗(25.8%对32.9%)的发生率有所下降。结论:在该中心,COVID-19引起了乳腺癌治疗的手术改变,包括重建手术和辅助治疗的减少。医疗保健中断和对COVID的恐惧可能导致诊断延迟,导致大流行期间4期疾病的频率更高,原位癌的比例更低。然而,手术时间没有延迟,手术量没有减少,手术类型也没有改变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of COVID-19 on Breast Cancer Management in a Multiethnic Middle-Income Asian Country Setting.

Objective: Coronavirus disease-2019 (COVID-19) has caused hospitals to suspend routine procedures. As the world recovers, there is concern that the outcome of many diseases has been impaired. This study aimed to assess the impact of the pandemic on breast cancer demography, clinicopathological characteristics and patient management at a teaching hospital in Kuala Lumpur, Malaysia.

Materials and methods: Pre-COVID data were collected between January 1, 2019, to March 18, 2020, when a national lockdown was implemented, which caused the suspension of services at the breast clinic of University Malaya Medical Centre (UMMC). COVID data was obtained from March 2020 until June 2021.

Results: This study compared 374 breast cancer patients in the COVID-19 period with 382 patients in the pre-COVID period. There was no significant difference in the median (range) time to surgery between pre-COVID [45 (26.50-153.50) days] and COVID [44 (24.75-156.25) days] periods. The clinicopathological features of breast cancer showed reduction in in situ carcinoma and increase in Stage 4 diagnoses during the COVID period. There was a reduction in screening-detected carcinoma (9% vs. 12.3%), mastectomy followed by immediate reconstruction (5.6% vs. 14.5%) and adjuvant chemotherapy (25.8% vs. 32.9%) in the COVID period.

Conclusion: In this center COVID-19 caused operational changes in breast cancer management, including a reduction in reconstructive procedures and adjuvant treatment. Healthcare disruption and fear of COVID may have caused delayed diagnosis, resulting in a higher frequency of Stage 4 disease and lower proportion of in situ carcinoma during the pandemic. However, there was no delay in the time to surgery, reduction in surgical volume, or change in surgery types.

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