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Vanni G, Pellicciaro M, Materazzo M, Pedini D, Portarena I, Buonomo C, Perretta T, Rizza S, Pistolese CA, Buonomo OC. Advanced Stages and Increased Need for Adjuvant Treatments in Breast Cancer Patients: The Effect of the One-year COVID-19 Pandemic. Anticancer Res 2021; 41:2689-2696. [PMID: 33952500 DOI: 10.21873/anticanres.15050] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The COVID-19 lockdown includes restrictive measures and temporary health system reorganization. Resources were shifted to COVID-19 patients, screening programs were temporary suspended, and oncological care suffered slow-down. The aim of the study was to evaluate the impact of these measures on breast cancer patients. PATIENTS AND METHODS All breast cancer patients referred to our unit from February 21, 2019 to February 21, 2021 were enrolled. Type of treatments and surgery, TNM, tumor diameter, and predictive and prognostic factors were analyzed. RESULTS Out of 445 patients with a breast cancer diagnosis, 182 (40.9%) were enrolled in the COVID-19 group (from February 21, 2010 to February 21, 2021). These patients were compared with 263 (59.1%) patients pre-COVID-19. Tumor diameters were bigger in the COVID-19 group. Type of surgery and N staging were statistically significantly different. Extreme advanced disease incidence was significantly different between the groups (2.7% COVID-19 group vs. 0 pre-COVID-19 group, p=0.011). Incidence of post-surgical radiation-therapy was higher in the COVID-19 group. Other variables analyzed were comparable without a statistically significant difference. CONCLUSION COVID-19 led to increased tumor dimensions, advanced N-staging, and increased need for adjuvant treatments in breast cancer.
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Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy;
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Domiziana Pedini
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Ilaria Portarena
- Department of Oncology, Policlinico Tor Vergata University, Rome, Italy
| | - Chiara Buonomo
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Rome, Italy
| | - Tommaso Perretta
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Stefano Rizza
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Chiara Adriana Pistolese
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
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Vanni G, Tazzioli G, Pellicciaro M, Materazzo M, Paolo O, Cattadori F, Combi F, Papi S, Pistolese CA, Cotesta M, Santori F, Caspi J, Chiaravalloti A, Muscoli S, Lombardo V, Grasso A, Caggiati L, Raselli R, Palli D, Altomare V, D'Angelillo RM, Palombi L, Buonomo OC. Delay in Breast Cancer Treatments During the First COVID-19 Lockdown. A Multicentric Analysis of 432 Patients. Anticancer Res 2020; 40:7119-7125. [PMID: 33288611 DOI: 10.21873/anticanres.14741] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Extraordinary restrictions aimed to limit Sars-CoV-2 spreading; they imposed a total reorganization of the health-system. Oncological treatments experienced a significant slowdown. The aim of our multicentric retrospective study was to evaluate screening suspension and surgical treatment delay during COVID-19 and the impact on breast cancer presentation. PATIENTS AND METHODS All patients who underwent breast surgery from March 11, 2020 to May 30, 2020 were evaluated and considered as the Lockdown group. These patients were compared with similar patients of the previous year, the Pre-Lockdown group. RESULTS A total of 432 patients were evaluated; n=223 and n=209 in the Lockdown and Pre-lockdown-groups, respectively. At univariate analysis, waiting times, lymph-nodes involvement and cancer grading, showed a statistically significant difference (p<0.05). Multivariate analysis identified waiting-time on list (OR=1.07) as a statistically significant predictive factor of lymph node involvement. CONCLUSION Although we did not observe a clinically evident difference in breast cancer presentation, we reported an increase in lymph node involvement.
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Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy
| | - Giovanni Tazzioli
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy;
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy
| | - Orsaria Paolo
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Francesca Cattadori
- Breast Surgery, Breast Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Francesca Combi
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilia, Modena, Italy.,Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy.,Breast Surgery, Breast Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.,PhD Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona Papi
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Adriana Pistolese
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Maria Cotesta
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy
| | - Francesca Santori
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy
| | - Jonathan Caspi
- Tor Vergata School of Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.,IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, Italy
| | - Saverio Muscoli
- Department of Cardiovascular Disease, Tor Vergata University, Rome, Italy
| | - Vittorio Lombardo
- Department of General Surgery, I.R.C.C.S. Centro Neurolesi Bonino Pulejo P.O. Piemnote, Messina, Italy
| | - Antonella Grasso
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Lorenza Caggiati
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Roberta Raselli
- Breast Surgery, Breast Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Dante Palli
- Breast Surgery, Breast Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Vittorio Altomare
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Rolando Maria D'Angelillo
- Radiotherapy Unit, Department of Oncology and Hematology, Policlinico Tor Vergata University, Rome, Italy
| | - Leonardo Palombi
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy
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