TY - JOUR
T1 - Time to Treatment Initiation for Breast Cancer During the 2020 COVID-19 Pandemic
AU - Hawrot, Kathryn
AU - Shulman, Lawrence N.
AU - Bleiweiss, Ira J.
AU - Wilkie, Elizabeth J.
AU - Frosch, Zachary A.K.
AU - Jankowitz, Rachel C.
AU - Laughlin, Amy I.
N1 - Publisher Copyright:
© American Society of Clinical Oncology.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - PURPOSE: The COVID-19 pandemic has posed significant pressures on healthcare systems, raising concern that related care delays will result in excess cancer-related deaths. Because data regarding the impact on patients with breast cancer are urgently needed, we aimed to provide a preliminary estimate of the impact of COVID-19 on time to treatment initiation (TTI) for patients newly diagnosed with breast cancer cared for at a large academic center.METHODS: We conducted a retrospective study of patients with newly diagnosed early-stage breast cancer between January 1, 2020, and May 15, 2020, a time period during which care was affected by COVID-19, and an unaffected cohort diagnosed between January 1, 2018 and May 15, 2018. Outcomes included patient volume, TTI, and initial treatment modality. Adjusted TTI was compared using multivariable linear regression.RESULTS: Three hundred sixty-six patients were included. There was an 18.8% decrease in patient volume in 2020 (n = 164) versus 2018 (n = 202). There was no association between time of diagnosis (pre-COVID-19 or during COVID-19) and adjusted TTI (
P = .926). There were fewer in situ diagnoses in the 2020 cohort (
P = .040). There was increased use of preoperative systemic therapy in 2020 (43.9% overall, 20.7% chemotherapy, and 23.2% hormonal therapy) versus 2018 (16.4% overall, 12.4% chemotherapy, and 4.0% hormonal therapy) (
P < .001).
CONCLUSION: TTI was maintained among patients diagnosed and treated for breast cancer during the COVID-19 pandemic at a single large academic center. There was a decrease in patient volume, specifically in patients with in situ disease and a shift in initial therapy toward the use of preoperative hormonal therapy.
AB - PURPOSE: The COVID-19 pandemic has posed significant pressures on healthcare systems, raising concern that related care delays will result in excess cancer-related deaths. Because data regarding the impact on patients with breast cancer are urgently needed, we aimed to provide a preliminary estimate of the impact of COVID-19 on time to treatment initiation (TTI) for patients newly diagnosed with breast cancer cared for at a large academic center.METHODS: We conducted a retrospective study of patients with newly diagnosed early-stage breast cancer between January 1, 2020, and May 15, 2020, a time period during which care was affected by COVID-19, and an unaffected cohort diagnosed between January 1, 2018 and May 15, 2018. Outcomes included patient volume, TTI, and initial treatment modality. Adjusted TTI was compared using multivariable linear regression.RESULTS: Three hundred sixty-six patients were included. There was an 18.8% decrease in patient volume in 2020 (n = 164) versus 2018 (n = 202). There was no association between time of diagnosis (pre-COVID-19 or during COVID-19) and adjusted TTI (
P = .926). There were fewer in situ diagnoses in the 2020 cohort (
P = .040). There was increased use of preoperative systemic therapy in 2020 (43.9% overall, 20.7% chemotherapy, and 23.2% hormonal therapy) versus 2018 (16.4% overall, 12.4% chemotherapy, and 4.0% hormonal therapy) (
P < .001).
CONCLUSION: TTI was maintained among patients diagnosed and treated for breast cancer during the COVID-19 pandemic at a single large academic center. There was a decrease in patient volume, specifically in patients with in situ disease and a shift in initial therapy toward the use of preoperative hormonal therapy.
KW - Breast Neoplasms/drug therapy
KW - COVID-19
KW - Female
KW - Humans
KW - Pandemics
KW - Retrospective Studies
KW - SARS-CoV-2
KW - Time-to-Treatment
UR - http://www.scopus.com/inward/record.url?scp=85116958768&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:000718325700006&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1200/OP.20.00807
DO - 10.1200/OP.20.00807
M3 - Article
C2 - 33710914
SN - 2688-1527
VL - 17
SP - 534
EP - 540
JO - JCO Oncology Practice
JF - JCO Oncology Practice
IS - 9
ER -
