medwireNews: Rates of breast cancer surgery, imaging, and genetic testing in the USA have dropped during the COVID-19 pandemic, study findings suggest.
“The cessation of elective health care services due to the emergence of COVID-19 may have far-reaching consequences on health care delivery in the United States,” say the researchers. They hope that by quantifying the impact on breast cancer screening, diagnosis, and treatment, the findings may “alter the management of future outbreaks and illuminate the current path to normalization.”
As reported in Cancer, the research team examined user data provided by a risk assessment company from 2 February to 11 April 2020 as a proxy for the use of breast surgery, imaging, and genetic consultation services across the USA.
The number of breast surgeries first declined in the week beginning 8 March by 18.2%, from 822 surgical consultations in the previous week to 720. There was a significant overall downward trend in consultations during the rest of the study period, with an average weekly decline of 20.5% and a maximum decline of 35.5%.
When stratified by breast cancer status, surgical consultations declined by a maximum of 34.4% between the weeks beginning 1 March and 8 March, which was “followed by a slight increment in the number of cases in the following weeks,” report the study authors.
They note that although breast cancer surgery consultations are “currently not declining, a decrease is expected in the near future as fewer screen-detected cancers are found.” This is expected to occur in line with the “particularly ominous” significant downward trend in breast imaging, which “may alter disease progression not only for patients with cancers diagnosed during this time frame, but also going forward.”
Indeed, there was an initial 51.3% decline in breast imaging during the week beginning 15 March when compared to the previous week – from 24,969 to 12,166 mammograms. This downward trend in breast imaging remained significant throughout the study period, with an average weekly decline of 61.7% and a maximum of 72.1%.
“We can assume that the drop is related to some extent to the percentage of imaging that accounts for screening,” comments the team.
The week beginning 15 March also saw a significant decrease in genetic consultations, with a 29.1% fall in consultations compared with the previous week (from 392 to 278 consultations). And again, the significant downward trend lasted the duration of the study period, with an average weekly decline of 26.4% and a maximum of 29.1%.
Kevin Hughes (Massachusetts General Hospital, Boston, USA) and colleagues emphasize that due to the perceived “lack of urgency” associated with these usually elective consultations, they have continued to decline even though “the initial consultation and testing can be done via telemedicine, with the saliva sample kit being sent to the patient’s home.”
The researchers therefore conclude: “Further evaluation of the impact of COVID-19 on the survival outcomes of patients with breast cancer is warranted.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd part of the Springer Nature Group
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Cancer 2020; doi:10.1002/cncr.33113