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06.01.2022 | COVID-19 | Epidemiology Zur Zeit gratis

Care in the time of COVID-19: impact on the diagnosis and treatment of breast cancer in a large, integrated health care system

verfasst von: Annie Tang, Elad Neeman, Brooke Vuong, Vignesh A. Arasu, Raymond Liu, Gillian E. Kuehner, Alison C. Savitz, Liisa L. Lyon, Prachi Anshu, Samantha A. Seaward, Milan D. Patel, Laurel A. Habel, Lawrence H. Kushi, Margaret Mentakis, Eva S. Thomas, Tatjana Kolevska, Sharon B. Chang, on behalf of The Permanente Medical Group Breast Research Collaborative

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2022

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Abstract

Purposes

To delineate operational changes in Kaiser Permanente Northern California breast care and evaluate the impact of these changes during the initial COVID-19 Shelter-in-Place period (SiP, 3/17/20–5/17/20).

Methods

By extracting data from institutional databases and reviewing electronic medical charts, we compared clinical and treatment characteristics of breast cancer patients diagnosed 3/17/20–5/17/20 to those diagnosed 3/17/19–5/17/2019. Outcomes included time from biopsy to consultation and treatment. Comparisons were made using Chi-square or Wilcoxon rank-sum tests.

Results

Fewer new breast cancers were diagnosed in 2020 during the SiP period than during a similar period in 2019 (n = 247 vs n = 703). A higher percentage presented with symptomatic disease in 2020 than 2019 (78% vs 37%, p < 0.001). Higher percentages of 2020 patients presented with grade 3 (37% vs 25%, p = 0.004) and triple-negative tumors (16% vs 10%, p = 0.04). A smaller percentage underwent surgery first in 2020 (71% vs 83%, p < 0.001) and a larger percentage had neoadjuvant chemotherapy (16% vs 11%, p < 0.001). Telehealth utilization increased from 0.8% in 2019 to 70.0% in 2020. Times to surgery and neoadjuvant chemotherapy were shorter in 2020 than 2019 (19 vs 26 days, p < 0.001, and 23 vs 28 days, p = 0.03, respectively).

Conclusions

During SiP, fewer breast cancers were diagnosed than during a similar period in 2019, and a higher proportion presented with symptomatic disease. Early-stage breast cancer diagnoses decreased, while metastatic cancer diagnoses remained similar. Telehealth increased significantly, and times to treatment were shorter in 2020 than 2019. Our system continued to provide timely breast cancer treatment despite significant pandemic-driven disruption.

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Titel: Care in the time of COVID-19: impact on the diagnosis and treatment of breast cancer in a large, integrated health care system
verfasst von: Annie Tang
Elad Neeman
Brooke Vuong
Vignesh A. Arasu
Raymond Liu
Gillian E. Kuehner
Alison C. Savitz
Liisa L. Lyon
Prachi Anshu
Samantha A. Seaward
Milan D. Patel
Laurel A. Habel
Lawrence H. Kushi
Margaret Mentakis
Eva S. Thomas
Tatjana Kolevska
Sharon B. Chang
on behalf of The Permanente Medical Group Breast Research Collaborative
Publikationsdatum: 06.01.2022
Verlag: Springer US
Schlagwort: COVID-19
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 3/2022
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-021-06468-1

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Care in the time of COVID-19: impact on the diagnosis and treatment of breast cancer in a large, integrated health care system