Multidisciplinary Oncologic Center, Antwerp University Hospital, Edegem, Belgium.
European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy.
Eur J Cancer. 2022 Dec;177:72-79. doi: 10.1016/j.ejca.2022.09.027. Epub 2022 Oct 12.
We analysed the impact of the SARS-CoV-2 pandemic (COVID-19) on the quality of breast cancer care in certified EUSOMA (European Society of Breast Cancer Specialists) breast centres.
The results of the EUSOMA quality indicators were compared, based on pseudonymised individual records, for the periods 1 March 2020 till 30 June 2020 (first COVID-19 peak in most countries in Europe) and 1 March 2019 till 30 June 2019. In addition, a questionnaire was sent to the participating Centres for investigating the impact of the COVID-19 pandemic on the organisation and the quality of breast cancer care.
Forty-five centres provided data and 31 (67%) responded to the questionnaire. The total number of new cases dropped by 19% and there was a small significant higher tumour (p = 0.003) and lymph node (p = 0.011) stage at presentation. Comparing quality indicators (12,736 patients) by multivariable analysis showed mostly non-significant differences. Surgery could be performed in a COVID-free zone in 94% of the centres, COVID testing was performed before surgery in 96% of the centres, and surgical case load was reduced in 55% of the centres. Modifications of the indications for neoadjuvant endocrine therapy, chemotherapy, and targeted therapy were necessary in 23%, 23%, and 10% of the centres; changes in indications for adjuvant endocrine, chemo-, targeted, immune, and radiotherapy in 3%, 19%, 3%, 6%, and 10%, respectively.
Quality of breast cancer care was well maintained in EUSOMA breast centres during the first wave of the COVID-19 pandemic. A small but significantly higher tumour and lymph node stage at presentation was observed.
我们分析了 2019 年冠状病毒病(COVID-19)大流行(SARS-CoV-2 大流行)对已通过认证的欧洲乳腺肿瘤学会(EUSOMA)乳腺中心乳腺癌治疗质量的影响。
根据匿名个体记录,比较了 EUSOMA 质量指标的结果,比较时段为 2020 年 3 月 1 日至 2020 年 6 月 30 日(欧洲大多数国家的第一波 COVID-19 高峰)和 2019 年 3 月 1 日至 2019 年 6 月 30 日。此外,还向参与中心发送了一份调查问卷,以调查 COVID-19 大流行对乳腺癌护理的组织和质量的影响。
45 个中心提供了数据,其中 31 个(67%)中心回复了调查问卷。新病例总数下降了 19%,就诊时肿瘤(p=0.003)和淋巴结(p=0.011)分期略有升高。通过多变量分析比较质量指标(12736 例患者),大多数差异无统计学意义。94%的中心能够在无 COVID-19 的区域进行手术,96%的中心在手术前进行了 COVID 检测,55%的中心减少了手术病例量。23%、23%和 10%的中心需要修改新辅助内分泌治疗、化疗和靶向治疗的适应证;3%、19%、3%、6%和 10%的中心需要修改辅助内分泌、化疗、靶向、免疫和放疗的适应证。
在 COVID-19 大流行的第一波期间,EUSOMA 乳腺中心的乳腺癌治疗质量得到了很好的维持。就诊时观察到肿瘤和淋巴结分期略有升高,但有统计学意义。