Major impact of COVID-19 pandemic on breast cancer care reported

In In The News by Barbara Jacoby

By: Shreeya Nanda


A survey of Italian breast cancer units has highlighted the severe impact of the global SARS-CoV-2 outbreak on the management of individuals with breast cancer.

“The results of our survey highlight a decrease in the overall performance of the Italian Breast Units due to the Covid-19 pandemic,” say the researchers.

“At the same time, they stress the need to protect both health facilities and specialized personnel in order to return soon to deliver optimal support.”

The survey, comprising 17 questions, was sent out on 2 April 2020 and completed by the clinical directors from 100 of the 133 breast cancer units affiliated with the nonprofit organization Senonetwork Italia. Fifty-eight percent of the responding centers were located in northern Italy, with 28% and 14% located in the central and southern parts of the country, respectively.

The majority (88%) of the breast cancer units are part of hospitals involved in the care of people with COVID-19, and two-thirds (66%) reported major organizational changes, such as the merging of departments and transfer of patients and physicians.

In almost a quarter (23%) of the units, the weekly multidisciplinary meeting was either discontinued or rescheduled to be less frequent, while decisions were made at a meeting of only the core team of physicians in 33% of cases. The meetings switched to a virtual format in 38% of units.

Radiology services appeared to be affected the most, with a major decrease in routine activities (defined as >50% reduction) reported by 38% of the units. This compared with major decreases in surgery, medical oncology, and radiotherapy services in a respective 22%, 11%, and 5% of units.

However, 38% of units had a decrease in weekly surgical procedures of at least 30%, report Lucio Fortunato (San Giovanni-Addolorata Hospital, Rome, Italy) and team.

Personnel tested positive for SARS-CoV-2 infection in 35% of units, and the same proportion of units reported that one or more healthcare providers had been quarantined since the start of the pandemic.

Over half (58%) of the unit respondents believe that the problems caused by the emergency can be addressed, whereas 21% believe that the pandemic may “profoundly” impact the management of individual breast cancer patients and 42% believe that the pandemic hampered patients’ access to the most appropriate treatment.

“Despite all this, the vast majority of women were reported to show an accommodating and understanding attitude towards the difficulties experienced by the Centers,” write Fortunato et al in Clinical Breast Cancer.

They conclude that these “[d]ata indicate a major health issue regarding an adequate and prompt access to treatment, and policy makers should take this into account.”

The team continues: “If not reversed by appropriate actions, we might face in the next future an increased number of women with advanced breast cancer at diagnosis, with the consequence of a decreased possibility to cure.”