Hui Ng Jing, Hoong See Mee, Min Tneoh Jia, Sze Teh Mei, Danaee Mahmoud, Latiff Nur Shahirah Abdul, Murali Abigail Ashwini, Lai Lee Lee
Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Breast Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Eur J Breast Health. 2023 Apr 1;19(2):177-183. doi: 10.4274/ejbh.galenos.2023.2022-12-6. eCollection 2023 Apr.
Coronavirus disease-2019 (COVID-19) has caused hospitals to suspend routine procedures. As the world recovers, there is concern that the outcome of many diseases has been impaired. This study aimed to assess the impact of the pandemic on breast cancer demography, clinicopathological characteristics and patient management at a teaching hospital in Kuala Lumpur, Malaysia.
Pre-COVID data were collected between January 1, 2019, to March 18, 2020, when a national lockdown was implemented, which caused the suspension of services at the breast clinic of University Malaya Medical Centre (UMMC). COVID data was obtained from March 2020 until June 2021.
This study compared 374 breast cancer patients in the COVID-19 period with 382 patients in the pre-COVID period. There was no significant difference in the median (range) time to surgery between pre-COVID [45 (26.50-153.50) days] and COVID [44 (24.75-156.25) days] periods. The clinicopathological features of breast cancer showed reduction in carcinoma and increase in Stage 4 diagnoses during the COVID period. There was a reduction in screening-detected carcinoma (9% vs. 12.3%), mastectomy followed by immediate reconstruction (5.6% vs. 14.5%) and adjuvant chemotherapy (25.8% vs. 32.9%) in the COVID period.
In this center COVID-19 caused operational changes in breast cancer management, including a reduction in reconstructive procedures and adjuvant treatment. Healthcare disruption and fear of COVID may have caused delayed diagnosis, resulting in a higher frequency of Stage 4 disease and lower proportion of carcinoma during the pandemic. However, there was no delay in the time to surgery, reduction in surgical volume, or change in surgery types.
2019冠状病毒病（COVID-19）导致医院暂停常规手术。随着世界的复苏，人们担心许多疾病的治疗结果受到了影响。本研究旨在评估疫情对马来西亚吉隆坡一家教学医院乳腺癌人口统计学、临床病理特征及患者管理的影响。
收集2019年1月1日至2020年3月18日（全国实施封锁，导致马来亚大学医学中心（UMMC）乳腺诊所服务暂停）的COVID疫情前数据。COVID疫情数据取自2020年3月至2021年6月。
本研究将COVID-19期间的374例乳腺癌患者与COVID疫情前的382例患者进行了比较。COVID疫情前[45（26.50 - 153.50）天]和COVID期间[44（24.75 - 156.25）天]的中位（范围）手术时间无显著差异。乳腺癌的临床病理特征显示，COVID期间癌的发生率降低，IV期诊断增加。COVID期间筛查发现的癌（9%对12.3%）、乳房切除术后立即重建（5.6%对14.5%）和辅助化疗（25.8%对32.9%）有所减少。
在该中心，COVID-19导致了乳腺癌管理的操作变化，包括重建手术和辅助治疗的减少。医疗保健中断和对COVID的恐惧可能导致了诊断延迟，从而在疫情期间导致IV期疾病的发生率更高，癌的比例更低。然而，手术时间没有延迟，手术量没有减少，手术类型也没有改变。
