Impact of COVID-19 pandemic on health care attention on breast cancer patients

BACKGROUND: Health care in relation to breast cancer has been negatively affected by COVID-19 pandemic. This study aims to estimate the impact of the pandemic on health care related to breast cancer at Hospital de la Santa Creu i Sant Pau (HSCSP), Barcelona, Spain. METHODS: This retrospective cohort study estimated the impact of pandemic during its first year on patients diagnosed with breast cancer undergoing treatment, follow-up, and control at HSCSP, and performed a comparative analysis with patients diagnosed the previous year in relation to the clinical characteristics, the treatments and the health care received. RESULTS: Data from 408 patients were analyzed, 217 (53.19%) from the group diagnosed the year before the pandemic (GC) and 191 (48.81%) from the group diagnosed during the pandemic (GP). No differences (p > 0.05) were found in clinical characteristics such as ECOG at diagnosis, histological type, presence of hormone receptors and HER2 receptors and prognostic stage. No significant differences (p > 0.05) were found in relation to survival at year. Most patients were diagnosed in HSCSP in assistencial circuit, a decrease of 10.02% was observed in the number of diagnoses in screening program. A difference of 3 days (p = 0.047) in diagnostic delay was found in GP in HSCSP. 10.93% fewer surgeries (p = 0.021) were performed as first treatment in GP. CONCLUSIONS: 11.98% less breast cancer was diagnosed in HSCSP during COVID-19 pandemic. The difference in diagnostic delay was 3 days, with a scarce clinical relevance. A reduction of approximately 10% was found in patients diagnosed through the screening program, which could explain the lower number of surgeries performed as first treatment (91.7% patients diagnosed through screening have surgery as first treatment). No significant differences were found in the clinical characteristics, probably because the lockdown (3 months) was not enough, although studies with longer follow-up times are lacking. KEY MESSAGES: • During the COVID-19 pandemic, there were fewer breast cancer patients diagnosed through the screening program and fewer patients whose first treatment was surgical. • A delay of a few weeks in the start of treatment could result in a significant increase in mortality, this study showed that health care in the HSCSP was not greatly affected by the COVID-19 pandemic.