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COVID-19 大流行对乳腺癌患者临床辅助治疗的影响。

The impact of the COVID-19 pandemic in the clinical assistance to breast cancer patients.

机构信息

Faculty of Medicine, University of Porto, Porto, Portugal.

Breast Center, Centro Hospitalar Universitário São João, Porto, Portugal.

出版信息

Cancer Causes Control. 2024 Jan;35(1):63-72. doi: 10.1007/s10552-023-01762-3. Epub 2023 Aug 5.

Abstract

PURPOSE

We aimed to disclose the impact of the pandemic on breast cancer patients in a specialized breast cancer center (BCC).

METHODS

A total of 501 breast cancer patients with a first appointment in the BCC from April 1st, 2019 to March 31st, 2021 were divided into four consecutive periods of 6 months. Data from the homologous semesters was compared. Patients with an appointment in the BCC during the study period were eligible for the secondary aim of our study (BCC workload).

RESULTS

After the pandemic declaration (period 3), we found a decrease in the referral by screening programs (p = 0.002) and a reduction in the waiting time between the primary care referral and the first BCC appointment (p < 0.001). There were higher rates of palpable axillary nodes (p = 0.001), an increase in N stage 2 and 3 (p = 0.050), and a trend for primary endocrine therapy as the first treatment (p = 0.021) associated with higher rates of complete axillary node dissection (p = 0.030). In period 4, there were more outward diagnoses (p = 0.003) and a higher rate of surgery as the first treatment (p = 0.013).

CONCLUSION

COVID-19 pandemic implied a more advanced nodal stage, which may be related to the delay in breast cancer screening.

摘要

目的

我们旨在揭示疫情对专门乳腺癌中心(BCC)中乳腺癌患者的影响。

方法

共纳入 2019 年 4 月 1 日至 2021 年 3 月 31 日期间在 BCC 首次就诊的 501 例乳腺癌患者,将其分为 4 个连续的 6 个月时间段。比较同期同源数据。在研究期间在 BCC 预约的患者有资格参加我们研究的次要目标(BCC 工作量)。

结果

疫情宣布后(第 3 期),我们发现筛查项目的转诊量减少(p = 0.002),初级保健转诊和首次 BCC 预约之间的等待时间缩短(p < 0.001)。可触及腋窝淋巴结的比例更高(p = 0.001),N 分期 2 期和 3 期的比例增加(p = 0.050),且首次治疗采用内分泌治疗的趋势更高(p = 0.021),与之相关的完全腋窝淋巴结清扫术的比例更高(p = 0.030)。第 4 期,更多的患者是外出就诊(p = 0.003),且更多的患者以手术作为初始治疗(p = 0.013)。

结论

COVID-19 大流行导致了更晚期的淋巴结分期,这可能与乳腺癌筛查的延迟有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01ac/10764374/6a1b5cd2b600/10552_2023_1762_Fig1_HTML.jpg

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