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2019年冠状病毒病大流行对原发性乳腺癌护理的回顾性影响

Retrospective Impact of COVID-19 Pandemic on Primary Breast Cancer Care.

作者信息

Pruss Maximilian, Neubacher Melissa, Dietzel Frederic, Krawczyk Natalia, Cieslik Jan-Philipp, Mohrmann Svjetlana, Ruckhäberle Eugen, Sturm-Inwald Elisabeth C, Fehm Tanja N, Behrens Bianca

机构信息

Department of Obstetrics and Gynecology, University Hospital and Medical Faculty of the Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.

Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany.

出版信息

Breast Care (Basel). 2024 Oct;19(5):270-281. doi: 10.1159/000541015. Epub 2024 Aug 27.

Abstract

BACKGROUND

The COVID-19 pandemic has transformed breast cancer care for patients and healthcare providers. Circumstances varied greatly by region and hospital, depending on COVID-19 prevalence, case mix, hospital type, and available resources. These challenges have disrupted screening programs and have been particularly distressing for both women with a breast cancer diagnosis and their providers.

SUMMARY

This review explores the retrospective impact of the COVID-19 pandemic on primary breast cancer care. It analyzes changes in screening participation, diagnosis rates, treatment modalities, and the delivery of psycho-oncological support during the pandemic. The study found a significant reduction in breast cancer screenings and a subsequent stage shift in diagnoses, with fewer early-stage and more advanced-stage cancers being detected. Additionally, the review discusses the psychosocial challenges faced by patients and the adaptations made in care delivery, such as the increased use of telemedicine. Despite these challenges, the healthcare systems showed resilience, with core treatment services largely maintained and rapid adaptations to new care models.

KEY MESSAGES

There was a marked decrease in breast cancer screenings and early diagnoses during the pandemic, with a shift toward more advanced-stage detections. While there was an increased use of neoadjuvant therapies and telemedicine, essential breast cancer treatments were mostly sustained, reflecting the resilience of healthcare systems. The pandemic significantly impacted the mental health of breast cancer patients, exacerbating anxiety and depression and highlighting the need for improved psycho-oncological support. The full impact of these disruptions on long-term breast cancer outcomes remains uncertain, necessitating ongoing monitoring and adaptation of care strategies to mitigate adverse effects.

摘要

背景

新冠疫情改变了乳腺癌患者的治疗方式以及医疗服务提供者的工作模式。由于新冠疫情的流行程度、病例组合、医院类型和可用资源不同,各地和各医院的情况差异很大。这些挑战扰乱了筛查计划,对乳腺癌确诊女性及其医疗服务提供者都造成了极大困扰。

总结

本综述探讨了新冠疫情对原发性乳腺癌治疗的回顾性影响。它分析了疫情期间筛查参与情况、诊断率、治疗方式以及心理肿瘤学支持的提供情况的变化。研究发现乳腺癌筛查显著减少,随后诊断出现阶段转移,早期癌症检出减少,晚期癌症检出增加。此外,该综述还讨论了患者面临的社会心理挑战以及在医疗服务提供方面所做的调整,比如远程医疗的使用增加。尽管面临这些挑战,医疗系统仍展现出韧性,核心治疗服务基本得以维持,并迅速适应了新的护理模式。

关键信息

疫情期间乳腺癌筛查和早期诊断显著减少,诊断向更晚期阶段转移。虽然新辅助治疗和远程医疗的使用有所增加,但乳腺癌的基本治疗大多得以维持,这反映了医疗系统的韧性。疫情对乳腺癌患者的心理健康产生了重大影响,加剧了焦虑和抑郁,凸显了改善心理肿瘤学支持的必要性。这些干扰对乳腺癌长期治疗结果的全面影响仍不确定,因此有必要持续监测并调整护理策略以减轻不利影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f59d/11493392/cfcb80d46269/brc-2024-0019-0005-541015_F01.jpg

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