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

• Published in: Breast cancer research and treatment 2022-02, Vol.191 (3), p.665-675
• Main Authors: Tang, Annie, Neeman, Elad, Vuong, Brooke, Arasu, Vignesh A., Liu, Raymond, Kuehner, Gillian E., Savitz, Alison C., Lyon, Liisa L., Anshu, Prachi, Seaward, Samantha A., Patel, Milan D., Habel, Laurel A., Kushi, Lawrence H., Mentakis, Margaret, Thomas, Eva S., Kolevska, Tatjana, Chang, Sharon B.
• Format: Article
• Language: English
• Subjects: Adjuvant treatment; Biopsy; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - epidemiology; Breast Neoplasms - therapy; Cancer; Cancer research; Cancer therapies; Care and treatment; Chemotherapy; Coronaviruses; COVID-19; Delivery of Health Care, Integrated; Epidemiology; Female; Health care; Health maintenance organizations; Humans; Medical diagnosis; Medicine; Medicine & Public Health; Metastases; Metastasis; Oncology; Pandemics; Patients; Rankings; SARS-CoV-2; Surgery; Telemedicine; Tumors
• ISSN: 0167-6806; 1573-7217; 1573-7217
• DOI: 10.1007/s10549-021-06468-1

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