The impact of the COVID-19 pandemic in the clinical assistance to breast cancer patients

Purpose We aimed to disclose the impact of the pandemic on breast cancer patients in a specialized breast cancer center (BCC). Methods A total of 501 breast cancer patients with a first appointment in the BCC from April 1st, 2019 to March 31st, 2021 were divided into four consecutive periods of 6 months. Data from the homologous semesters was compared. Patients with an appointment in the BCC during the study period were eligible for the secondary aim of our study (BCC workload). Results After the pandemic declaration (period 3), we found a decrease in the referral by screening programs ( p = 0.002) and a reduction in the waiting time between the primary care referral and the first BCC appointment ( p < 0.001). There were higher rates of palpable axillary nodes ( p = 0.001), an increase in N stage 2 and 3 ( p = 0.050), and a trend for primary endocrine therapy as the first treatment ( p = 0.021) associated with higher rates of complete axillary node dissection ( p = 0.030). In period 4, there were more outward diagnoses ( p = 0.003) and a higher rate of surgery as the first treatment ( p = 0.013). Conclusion COVID-19 pandemic implied a more advanced nodal stage, which may be related to the delay in breast cancer screening. Graphical abstract