Objective: The coronavirus disease-2019 (COVID-19) pandemic caused some difficulties in the management of breast cancer, so we examined the effect of this challenging condition on the diagnosis and treatment of breast cancer.
Methods: In this study, the 26 month period from March 2019 to April 2021 was divided into two periods according to the start date of the pandemic. The previous 13 months were defined as A, the next 13 months as B, and the first 3 months of both periods were defined as A* and B*. All patients diagnosed with breast cancer were evaluated retrospectively based on hospital records, in terms of some characteristics like histopathological, and molecular subtypes of the tumor, primary systemic treatment (PST) frequency and its model, axillary staging method before PST, and surgical method. The results were evaluated with the chi-square test, and p>0.05 was statistically significant.
Results: All patients were female, 356 cases were in the A period, 30.3% of them had PST as neoadjuvant chemotherapy (NAC) and 37% (n=40) had sentinel lymph node biopsy before PST. There were 281 patients in period B, 116 cases received PST (41.2%); NAC and neoadjuvant endocrine therapy (NET) were staged radiologically and cytologically if necessary. When the findings of periods A and B (and A*-B*) were compared, the difference in PST in B compared to period A was statistically significant (p=0.005), insignificant for NAC (p=0.849), and highly significant for axillary approach and NET (p=0.000). In period B, more breast-conserving surgery (BCS) was applied, which may have been due to more initiation of PST. Overall, results in A* and B* were broadly similar to periods A and B.
Conclusion: During the COVID-19 pandemic, some adjustments were made in breast cancer management plans. PST was applied more often, NET became an option to start treatment, the axillary staging was performed based on a non-invasive method and surgically, BCS was performed more frequently.