Arslan Bilal, Guler Erkan, Dag Ahmet, Afsin Tasdelen Halil, Okan Üstün Recep
General Surgery, Faculty of Medicine, Mersin University, Mersin, TUR.
General Surgery, Trabzon Kanuni Training and Research Hospital, Trabzon, TUR.
Cureus. 2024 Aug 9;16(8):e66501. doi: 10.7759/cureus.66501. eCollection 2024 Aug.
Introduction The coronavirus disease 2019 (COVID-19) outbreak, first reported in Wuhan, China, in December 2019, quickly hit the world in just one month, causing a global public health emergency. We aimed to investigate whether the COVID-19 pandemic caused a delay in the hospital admissions of breast cancer patients and diagnosis of breast cancer, thus increasing the tumor size and the stage of the disease. Materials and methods Included in the study were patients who underwent breast cancer surgery between 01/03/2019 and 01/03/2020 (pre-COVID-19, first period) and between 01/03/2020 and 01/03/2021 (post-COVID-19, second period). Three hundred and seventy patients with enough details were included, and details were analyzed retrospectively. Tumor characteristics of pre-COVID-19 breast cancer patients were compared with the tumor characteristics of post-COVID-19 breast cancer patients. Demographics, preoperative diagnosis, tumor properties, surgical procedure (breast-conserving surgery, modified radical mastectomy, simple mastectomy, skin-sparing mastectomy), tumor size, total lymph node number, metastatic lymph node number, locally advanced disease, metastatic disease, and neoadjuvant therapy were evaluated. Results The mean tumor size increased significantly in the post-COVID-19 primary surgery group (p=0.005). There is no significant relationship between the pre-COVID-19 and post-COVID-19 period and pT in the neoadjuvant received group (p>0.05). The presence of pT2+pT3+pT4 was statistically significantly higher in the post-COVID-19 primary surgery group (p=0.001). The mean value of metastatic lymph nodes dissected between pre-COVID-19 and post-COVID-19 primary surgery groups increased significantly (p=0.010). Pericapsular extension was higher in the post-primary surgery group (p=0.002). Conclusion During the COVID-19 outbreak, breast cancer patients have difficulty accessing healthcare services and hesitate to apply to hospitals to fear contracting the COVID-19 disease. This situation has led to delays in diagnosing breast cancer patients, increased tumor size and pT grade, increased number of metastatic lymph nodes, pericapsular extension, and the resulting disease often appearing in advanced sizes and stages.
引言 2019年12月首次在中国武汉报告的2019冠状病毒病（COVID-19）疫情，在短短一个月内迅速蔓延至全球，引发了全球公共卫生紧急事件。我们旨在调查COVID-19大流行是否导致乳腺癌患者住院延迟和乳腺癌诊断延迟，从而增加肿瘤大小和疾病分期。材料与方法 纳入研究的患者为在2019年3月1日至2020年3月1日（COVID-19之前，第一阶段）以及2020年3月1日至2021年3月1日（COVID-19之后，第二阶段）接受乳腺癌手术的患者。纳入了370例有足够详细信息的患者，并对详细信息进行回顾性分析。将COVID-19之前乳腺癌患者的肿瘤特征与COVID-19之后乳腺癌患者的肿瘤特征进行比较。评估了人口统计学、术前诊断、肿瘤特性、手术方式（保乳手术、改良根治性乳房切除术、单纯乳房切除术、保留皮肤乳房切除术）、肿瘤大小、总淋巴结数、转移淋巴结数、局部晚期疾病、转移性疾病和新辅助治疗情况。结果 COVID-19之后初次手术组的平均肿瘤大小显著增加（p=0.005）。在接受新辅助治疗的组中，COVID-19之前和之后时期与pT之间无显著关系（p>0.05）。COVID-19之后初次手术组中pT2+pT3+pT4的存在在统计学上显著更高（p=0.001）。COVID-19之前和之后初次手术组之间切除的转移淋巴结的平均值显著增加（p=0.010）。初次手术后组的包膜外扩展更高（p=0.002）。结论 在COVID-19疫情期间，乳腺癌患者难以获得医疗服务，因担心感染COVID-19疾病而犹豫是否前往医院就诊。这种情况导致乳腺癌患者诊断延迟，肿瘤大小和pT分级增加，转移淋巴结数量增加，包膜外扩展，且由此导致的疾病往往以晚期大小和分期出现。
