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CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(09): 871-877
DOI: 10.1055/s-0042-1749207
Original Article
Mastology

The COVID-19 Pandemic Impact on Breast Cancer Diagnosis: A Retrospective Study

O impacto da pandemia de COVID-19 no diagnóstico de câncer de mama: Um estudo retrospectivo
Erika Marina Solla Negrao 
1   Cancer Prevention Institute, Hospital do Câncer de Barretos Barretos, SP, Brazil
,
Cesar Cabello 
2   Obstetrics and Gynecology Department, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Livia Conz 
1   Cancer Prevention Institute, Hospital do Câncer de Barretos Barretos, SP, Brazil
2   Obstetrics and Gynecology Department, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Edmundo Carvalho Mauad 
1   Cancer Prevention Institute, Hospital do Câncer de Barretos Barretos, SP, Brazil
,
Luiz Carlos Zeferino 
2   Obstetrics and Gynecology Department, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Diama Bhadra Vale 
2   Obstetrics and Gynecology Department, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Abstract

Objective This study aimed to evaluate the diagnostic profile of breast cancer cases during the coronavirus disease 2019 (COVID-19) pandemic compared with the previous year.

Methods It is a retrospective study of cases diagnosed by a reference service in the public health system of Campinas, SP, Brazil. Two periods were analyzed: March to October 2019 (preCOVID period) and March to October 2020 (COVID-period). All women diagnosed during the periods were included. The Chi-Squared or Fisher exact and Mann-Whitney tests were used.

Results In the preCOVID and COVID periods, breast cancers were diagnosed, respectively, in 115 vs 59 women, and the mean ages at diagnosis were 55 and 57 years (p = 0.339). In the COVID period, the family history of breast cancer was more observed (9.6% vs 29.8%, p < 0.001), cases were more frequently symptomatic (50.4% vs 79.7%, p < 0.001) and had more frequently palpable masses (56.5% vs 79.7%, p = 0.003). In symptomatic women, the mean number of days from symptom to mammography were 233.6 (458.3) in 2019 and 152.1 (151.5) in 2020 (p = 0.871). Among invasive tumors, the proportion of breast cancers in stages I and II was slightly higher in the COVID period, although not significantly (76.7% vs 82.4%, p = 0.428). Also in the COVID period, the frequency of luminal A-like tumors was lower (29.2% vs 11.8%, p = 0.018), of triple-negative tumors was twice as high (10.1% vs 21.6%, p = 0.062), and of estrogen receptor-positive tumors was lower (82.2% vs 66.0%, p = 0.030).

Conclusion During the COVID-19 pandemic, breast cancer diagnoses were reduced. Cases detected were suggestive of a worse prognosis: symptomatic women with palpable masses and more aggressive subtypes. Indolent tumors were those more sensitive to the interruption in screening.

Resumo

Objetivo Este estudo teve como objetivo avaliar o perfil diagnóstico dos casos de câncer de mama na pandemia de coronavirus disease 2019 (COVID-19) em comparação com o ano anterior.

Métodos Este é um estudo retrospectivo de casos diagnosticados em um serviço de referência da rede pública de saúde de Campinas, SP, Brasil. Foram analisados dois períodos: de março a outubro de 2019 (período pré-COVID) e de março a outubro de 2020 (período COVID). Todas as mulheres diagnosticadas durante os períodos foram incluídas. Foram utilizados os testes do qui-quadrado ou exato de Fisher e Mann-Whitney.

Resultados Nos períodos pré-COVID e COVID, o câncer de mama foi diagnosticado, respectivamente, em 115 e 59 mulheres, e a média de idade no diagnóstico foi de 55 e 57 anos (p = 0,339). No período COVID, foram mais frequentes a história familiar de câncer de mama (9,6% vs 29,8%, p < 0,001), casos sintomáticos (50,4% vs 79,7%, p < 0,001) e com massas palpáveis (56,5% vs 79,7%, p = 0,003). Nas mulheres sintomáticas, a média de dias desde os sintomas até a mamografia foi de 233,6 (458,3) no pré-COVID e 152,1 (151,5) no COVID (p = 0,871). Entre os tumores invasivos no período COVID, a proporção de cânceres nos estágios I e II foi ligeiramente maior, porém não significativa (76,7% vs 82,4%, p = 0,428). Ainda no período COVID, a frequência de tumores tipo luminal A-like foi menor (29,2% vs 11,8%, p = 0,018), de tumores triplo-negativos foi duas vezes maior (10,1% vs 21,6%, p = 0,062), e de tumores positivos para receptor de estrogênio foi inferior (82,2% vs 66,0%, p = 0,030).

Conclusão Durante a pandemia de COVID-19, houve uma redução no diagnóstico de câncer de mama. Os casos detectados eram sugestivos de pior prognóstico: mulheres sintomáticas com massas palpáveis e subtipos mais agressivos. Os tumores indolentes foram os mais sensíveis à interrupção do rastreamento.

Keywords

breast neoplasms - early detection of cancer - quality of health care - COVID-19 - mammography

Palavras-chave

neoplasias da mama - detecção precoce de câncer - qualidade da assistência à saúde - COVID-19 - mamografia

Contributors

All authors participated in the concept and design of the study, as well as in the analysis and interpretation of data; draft or revision of the manuscript; and they have approved the manuscript as submitted. All authors are responsible for the reported research.




Publication History

Received: 20 November 2021

Accepted: 24 March 2022

Article published online:
06 June 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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