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William J. Gradishar, MD, FACP, FASCO


COVID-19 and Breast Cancer: Impact on Surgical Treatment and Breast Reconstruction

By: Joshua Swore
Posted: Wednesday, August 17, 2022

The effects of COVID-19 seem to include a significant decrease in surgical treatment for patients with breast cancer, according to a study published in the Journal of Surgical Oncology. “As the severity of the pandemic fluctuates, the effects of COVID-19 will likely continue to influence breast surgery and reconstruction practice patterns,” said Jonas A. Nelson, MD, MPH, of Memorial Sloan Kettering Cancer Center, New York, and colleagues.

The authors analyzed records of patients with breast cancer from 2017 to 2020, acquired from the National Surgical Quality Improvement Program. The group focused on the annual rates of lumpectomy, mastectomy, and breast reconstruction to better understand the impact COVID-19 had on patients’ treatment decisions.

The researchers found that 175,949 patients underwent a lumpectomy or mastectomy without breast reconstruction from 2017 to 2020. From 2019 to 2020, the patient volume decreased by 10.7%, from 45,882 patients in 2019 to 40,957 in 2020. Rates of lumpectomy decreased from 63.8% in 2017 to 61.6% in 2020; however, mastectomy rates increased from 36.2% to 38.4%. Furthermore, the length of hospital stays also decreased as a greater proportion of patient records reported stays of up to 3 days, compared with 4 or more days.

Analysis of breast reconstruction elicited varied results. The authors reported no significant change in the overall rates of breast reconstruction, but they found the rates of expander and alloplastic reconstruction increased from 64.0% to 68.4% and 84.8% to 86.6%, respectively. On the other hand, the rates of both direct-to-implant and autologous breast reconstruction decreased from 20.7% to 18.2% and 64.0% to 68.4%, respectively. Although the study highlights the broad effects of COVID-19 on breast cancer treatment, the authors noted the study limitations in tracking time-sensitive treatment decisions during the COVID-19 pandemic.

Disclosure: The study authors reported no conflicts of interest.

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