Cancer Prevention Institute, Barretos Cancer Hospital, Campinas, Brazil.
Obstetrics and Gynecology Department, University of Campinas, Campinas, Brazil.
J Med Screen. 2023 Mar;30(1):42-46. doi: 10.1177/09691413221122055. Epub 2022 Sep 7.
To evaluate the performance of breast cancer screening and early diagnosis during the pandemic, compared to the pre-pandemic period. The public referral centre for screening in Campinas, São Paulo State, Brazil.
This is an audit study of performance screening and diagnostic indicators. Two periods were analysed: 2019, the pre-COVID period, and 2020, the COVID period. All women who underwent mammography in these periods were included. Indicators were compared between periods, and the US Breast Cancer Surveillance Consortium benchmarks were used as a reference.
A comparison between the periods shows a reduction of 57.4% in screening and 4.4% in diagnosis using mammography. Cancer detection rate per 1000 screening mammograms dropped from 4.62 to 2.83 (p = 0.031), while it increased from 84.43 to 89.36 in diagnosis mammograms (p = 0.701), higher than the reference (34.4, p < 0.001). With regard to diagnosis, the proportion of minimal cancers was reduced (p = 0.005) and was lower than the reference (40.0%, p < 0.001), along with the proportion of node-negative invasive cancers (p < 0.001). The mean size of invasive tumours was similar in the two periods (32.50 mm and 33.40 mm, p = 0.808) but larger than the reference value (16.50 mm, p < 0.001). Recall rate was lower in the COVID period (22.55% vs. 27.37%, p = 0.015).
The COVID pandemic caused an overall decrease in breast screening and detection of breast cancer cases, although the reduction in number of diagnosis mammograms performed was minimal. Tumour mean size was large in both periods, the pandemic highlighting a previous profile of detection at an advanced stage.
评估疫情期间与疫情前相比，乳腺癌筛查和早期诊断的表现。巴西圣保罗州坎皮纳斯的公共筛查转诊中心。
这是一项关于筛查和诊断指标表现的审核研究。分析了两个时期：2019 年，即 COVID 前时期，和 2020 年，即 COVID 时期。所有在这些时期接受乳房 X 光检查的女性都包括在内。比较了两个时期的指标，并将美国乳腺癌监测联合会的基准作为参考。
两个时期的比较显示，乳房 X 光筛查的减少了 57.4%，诊断的减少了 4.4%。每 1000 例筛查性乳房 X 光检查的癌症检出率从 4.62 降至 2.83（p=0.031），而诊断性乳房 X 光检查的癌症检出率从 84.43 升至 89.36（p=0.701），高于参考值（34.4，p<0.001）。在诊断方面，最小癌症的比例降低（p=0.005），且低于参考值（40.0%，p<0.001），以及淋巴结阴性浸润性癌症的比例（p<0.001）。两个时期的浸润性肿瘤的平均大小相似（32.50 毫米和 33.40 毫米，p=0.808），但大于参考值（16.50 毫米，p<0.001）。在 COVID 期间，召回率较低（22.55%与 27.37%，p=0.015）。
COVID 大流行导致乳腺癌筛查和乳腺癌病例检出总体减少，尽管进行的诊断性乳房 X 光检查数量减少幅度很小。两个时期的肿瘤平均大小都较大，大流行凸显了之前在晚期发现的情况。
