Cancer Prevention Institute, Hospital do Câncer de Barretos Barretos, SP, Brazil.
Obstetrics and Gynecology Department, Universidade Estadual de Campinas, Campinas, SP, Brazil.
Rev Bras Ginecol Obstet. 2022 Sep;44(9):871-877. doi: 10.1055/s-0042-1749207. Epub 2022 Jun 6.
This study aimed to evaluate the diagnostic profile of breast cancer cases during the coronavirus disease 2019 (COVID-19) pandemic compared with the previous year.
It is a retrospective study of cases diagnosed by a reference service in the public health system of Campinas, SP, Brazil. Two periods were analyzed: March to October 2019 (preCOVID period) and March to October 2020 (COVID-period). All women diagnosed during the periods were included. The Chi-Squared or Fisher exact and Mann-Whitney tests were used.
In the preCOVID and COVID periods, breast cancers were diagnosed, respectively, in 115 vs 59 women, and the mean ages at diagnosis were 55 and 57 years ( = 0.339). In the COVID period, the family history of breast cancer was more observed (9.6% vs 29.8%, < 0.001), cases were more frequently symptomatic (50.4% vs 79.7%, < 0.001) and had more frequently palpable masses (56.5% vs 79.7%, = 0.003). In symptomatic women, the mean number of days from symptom to mammography were 233.6 (458.3) in 2019 and 152.1 (151.5) in 2020 ( = 0.871). Among invasive tumors, the proportion of breast cancers in stages I and II was slightly higher in the COVID period, although not significantly (76.7% vs 82.4%, = 0.428). Also in the COVID period, the frequency of luminal A-like tumors was lower (29.2% vs 11.8%, = 0.018), of triple-negative tumors was twice as high (10.1% vs 21.6%, = 0.062), and of estrogen receptor-positive tumors was lower (82.2% vs 66.0%, = 0.030).
During the COVID-19 pandemic, breast cancer diagnoses were reduced. Cases detected were suggestive of a worse prognosis: symptomatic women with palpable masses and more aggressive subtypes. Indolent tumors were those more sensitive to the interruption in screening.
本研究旨在评估 2019 年冠状病毒病（COVID-19）大流行期间与前一年相比乳腺癌病例的诊断特征。
这是巴西坎皮纳斯市公共卫生系统参考服务诊断病例的回顾性研究。分析了两个时期：2019 年 3 月至 10 月（前 COVID 期）和 2020 年 3 月至 10 月（COVID 期）。包括两个时期诊断的所有女性。使用卡方或 Fisher 精确检验和曼-惠特尼检验。
在前 COVID 和 COVID 期间，分别诊断出 115 例和 59 例乳腺癌，诊断时的平均年龄分别为 55 岁和 57 岁（=0.339）。在 COVID 期，更多观察到乳腺癌家族史（9.6%比 29.8%，<0.001），更多病例表现为症状（50.4%比 79.7%，<0.001）且更常触及肿块（56.5%比 79.7%，=0.003）。在有症状的女性中，从症状到乳房 X 线摄影的平均天数为 2019 年的 233.6（458.3）天和 2020 年的 152.1（151.5）天（=0.871）。在侵袭性肿瘤中，COVID 期 I 期和 II 期乳腺癌的比例略高，但无统计学意义（76.7%比 82.4%，=0.428）。同样在 COVID 期，luminal A 样肿瘤的频率较低（29.2%比 11.8%，=0.018），三阴性肿瘤的频率是其两倍（10.1%比 21.6%，=0.062），雌激素受体阳性肿瘤的频率较低（82.2%比 66.0%，=0.030）。
在 COVID-19 大流行期间，乳腺癌的诊断减少了。检测到的病例提示预后更差：有可触及肿块和侵袭性更强的亚型的症状性女性。惰性肿瘤对筛查中断更敏感。
