Division of General Surgery, University of British Columbia, Vancouver, BC, Canada.
Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada.
Breast Cancer Res Treat. 2021 Apr;186(2):519-525. doi: 10.1007/s10549-020-06008-3. Epub 2020 Nov 4.
In British Columbia (BC), there have been 2790 confirmed COVID-19 cases as of June 20, 2020. The aim of this project is to capture the effect of COVID-19 on the volume of surgery and adaptations to the surgical care of patients at a breast centre in BC.
All proven or suspected breast cancer cases treated with surgery between March 16, 2019 and April 30, 2019 and March 16, 2020 and April 30, 2020 through the Providence Breast Centre were included in this review. The date ranges in 2020 mark the early COVID-19 pandemic period in BC and the large shift in operating room access during this time.
In 2019, 99 patients underwent surgery for proven breast cancer and 30 patients for suspected breast cancer. In 2020, 162 patients underwent surgery for breast cancer and 34 for suspected breast cancer. Wait times from core biopsy to surgery and surgery to oncology consultation were improved in 2020 with a reduction of core biopsy to surgery time from 58 to 28 days for patients seen during the pandemic. There was an increased use of regional anesthesia and same day discharge compared to 2019 with increases in regional anesthesia (41%-89%) and same day discharge (64%-86%) after adaptations to the pandemic were implemented.
Changes such as improved access to telemedicine, timing for cancer surgeries, and safer anesthetic techniques in response to the pandemic will change breast cancer surgical care beyond the pandemic era. Centralization and team-based care is the way forward.
截至 2020 年 6 月 20 日，不列颠哥伦比亚省（BC）已确诊 COVID-19 病例 2790 例。本项目旨在了解 COVID-19 对 BC 一家乳房中心手术量和患者手术护理适应措施的影响。
本回顾性研究纳入了 2019 年 3 月 16 日至 2019 年 4 月 30 日和 2020 年 3 月 16 日至 2020 年 4 月 30 日期间在 Providence 乳房中心接受手术治疗的确诊或疑似乳腺癌病例。2020 年的日期范围标志着 BC 早期 COVID-19 大流行时期，以及在此期间手术室准入的重大转变。
2019 年，99 例确诊乳腺癌患者和 30 例疑似乳腺癌患者接受了手术治疗。2020 年，162 例乳腺癌患者和 34 例疑似乳腺癌患者接受了手术治疗。2020 年，从核心活检到手术和手术到肿瘤会诊的等待时间得到了改善，大流行期间就诊的患者从核心活检到手术的时间从 58 天减少到 28 天。与 2019 年相比，区域麻醉和当日出院的使用率有所增加，区域麻醉（41%-89%）和当日出院（64%-86%）的比例增加，这是在适应大流行的措施实施后的结果。
为应对大流行而改进远程医疗的可及性、癌症手术时间和更安全的麻醉技术等变化，将改变大流行后时期的乳腺癌手术护理。集中化和以团队为基础的护理是未来的发展方向。
