Soyder Aykut, Güldoğan Nilgün, Isıklar Aysun, Arıbal Erkin, Başaran Gül
Department of General Surgery, Acıbadem Altunizade Hospital, Breast Clınıc, İstanbul, Turkey.
Department of Radiology, Acıbadem Altunizade Hospital, Breast Clınıc, İstanbul, Turkey.
Breast Care (Basel). 2022 Feb 18;55(4):1-6. doi: 10.1159/000523673.
The COVID-19 pandemic has a worldwide negative impact on healthcare systems. This study aims to determine how the diagnosis, clinicopathological features, and treatment approaches of patients with breast cancer (BC) diagnosed at ≥65 years old were affected during the pandemic. This survey has shown that patients, especially the elderly, had to postpone their BC health problems or delay their routine controls due to the risk of COVID-19 transmission, high mortality rates due to comorbidity, and restrictions.
The medical records of 153 patients with BC diagnosed at ≥65 years old before (January-December 2019; group A, = 61) and during (March 2020-May 2021; group B, = 92) the COVID-19 pandemic were retrospectively analyzed. In addition, clinicopathological features of patients, including age, admission form, clinical stage, tumor (T) size-grade-histology-subtype, lymph node involvement, surgery type, and treatment protocols, were evaluated.
Patients mostly applied for screening purposes were included in group A and patients who frequently applied for diagnostic purposes due to their existing BC or other complaints were included in group B ( = 0.009). Group B patients had a higher clinical stage ( = 0.026) and had commonly larger ( = 0.020) and high-grade ( = 0.001) Ts. Thus, mastectomy and neoadjuvant systemic therapy were more commonly performed in group B ( = 0.041 and = 0.005).
The survey showed significant changes in BC diagnosis and treatment protocols for patients diagnosed at ≥65 years old during the COVID-19 pandemic. Postponing screening and delaying treatment leads to more advanced BC stages in elderly patients.
新冠疫情对全球医疗系统产生了负面影响。本研究旨在确定在疫情期间,65岁及以上乳腺癌(BC)患者的诊断、临床病理特征及治疗方法受到了怎样的影响。该调查显示,由于新冠病毒传播风险、合并症导致的高死亡率以及各种限制,患者,尤其是老年人,不得不推迟乳腺癌相关健康问题或延误常规检查。
回顾性分析了153例65岁及以上乳腺癌患者的病历,这些患者分别在新冠疫情之前(2019年1月至12月;A组,n = 61)和疫情期间(2020年3月至2021年5月;B组,n = 92)被诊断。此外,还评估了患者的临床病理特征,包括年龄、入院形式、临床分期、肿瘤(T)大小-分级-组织学-亚型、淋巴结受累情况、手术类型及治疗方案。
A组主要包括以筛查为目的就诊的患者,B组主要包括因现有乳腺癌或其他症状而频繁以诊断为目的就诊的患者(P = 0.009)。B组患者临床分期更高(P = 0.026),肿瘤通常更大(P = 0.020)且分级更高(P = 0.001)。因此,B组更常进行乳房切除术和新辅助全身治疗(P = 0.041和P = 0.005)。
该调查显示,在新冠疫情期间,65岁及以上乳腺癌患者的诊断和治疗方案发生了显著变化。筛查推迟和治疗延误导致老年患者的乳腺癌分期更晚。