Cihat AKSOY, Koray KOÇ, Kamil ÇIRA, Emel EMİR YETİM, Özgür ÖZBİLEK, Sinem ÇİL GÖNÜLCÜ, Günhan CAN

COVID-19 pandemisinin meme kanseri tanısına etkisinin değerlendirilmesi

Amaç COVID-19 pandemisi, rutin sağlık uygulamalarımızda ciddi değişikliklere neden oldu. Bu çalışma ile pandeminin meme kanseri tanısına etkisini belirlemeyi amaçladık. Materyal-Method Mart 2019-Ocak 2021 tarihleri arasında meme görüntülenmesi için başvuran hastaların tıbbi kayıtları geriye dönük olarak tarandı. BI-RADS kategori 4 ve 5 olan hastalardan ultrasonografi eşliğinde perkütan meme iğne kor biyopsi ve ultrasonografi eşliğinde tel ile işaretleme sonrası eksizyonel biyopsi yapılanlar çalışmaya dahil edildi. Çalışma süresi iki gruba ayrıldı; Mart 2019-Ocak 2020 pandemi öncesi ve Mart 2020-Ocak 2021 pandemi sonrası olarak gruplandırılmıştır. Bulgular Pandemi öncesi dönemde 9378 hastaya toplam 14200 meme görüntüleme tetkiki, pandemi sonrası dönemde ise 2375 hastaya 3778 meme görüntüleme tetkiki yapıldı. Hastaların yaş ortalaması 48,98±14,11 yıl idi. Pandemi öncesi dönemde biyopsi yapılan lezyon sayısı 201 (%1,4) iken, pandemi sonrası dönemde 61 (%1,6) idi. Malign meme lezyonlarının sayısı pandemi öncesi 97, pandemi sonrası 30 idi. Pandemi sonrası meme görüntüleme yapılan hasta sayısı, tetkik sayısı, biyopsi sayısı, malign lezyon sayısı sırasıyla %74, %73, %69 ve %69 azaldı. Tetkik sayısında en fazla azalma %97,55 ve %96,35 ile Nisan ve Mayıs aylarında olmuştur. Sonuç Pandemi ile birlikte hastaneye başvuran hasta sayısı, meme görüntüleme sayısı, biopsi sayısı ve tespit edilen malign meme lezyonlarının sayısı yaklaşık %70 oranında azaldı. Pandemi sürecinde hastaların düzenli kontrollerini aksattıkları, hastaneye başvuru sürelerinin uzadığı farkedilmiştir.

Anahtar Kelimeler:

COVID 19, pandemi, meme kanseri

Evaluation of the effect of COVID 19 pandemic on breast cancer diagnosis

Objective: The COVID-19 pandemic has caused serious changes in our routine healthcare practices. With this study, we aimed to determine the effect of the pandemic on the diagnosis of breast cancer. Methods:The medical records of patients who applied for breast imaging between March 2019 and January 2021 were retrospectively scanned. Among the patients diagnosed with BI-RADS category 4 and 5, those who had percutaneous ultrasound-guided core needle breast biopsy (CNBB) and excisional biopsy after ultrasound guided wire marking (UGWM) were included in the study. The study period was divided into two groups; March 2019-January 2020 was grouped as pre-pandemic and March 2020-January 2021 post-pandemic. Results:A total of, 14200 breast imaging examinations were performed in 9378 patients in the pre-pandemic period, and 3778 breast imaging examinations were performed in 2375 patients in the post-pandemic period. The mean age of the patients was 48.98±14.11 years. While the number of lesions biopsied was 201 (1.4%) in the pre-pandemic period, it was 61 (1.6%) in the post-pandemic period. The number of malignant breast lesions was 97 before the pandemic and 30 after the pandemic. After the pandemic, the number of patients undergoing breast imaging, the number of examinations, the number of biopsy, the number of malignant lesions decreased by 74%, 73%, 69% and 69%, respectively. The highest decrease in the number of examination was in April and May, with 97.55% and 96.35%. Conclusions:With the pandemic, the number of patients admitted to the hospital, the number of breast imaging, the number of biopsy and the number of malignant breast lesions detected decreased about 70%. It has been noticed that during the pandemic process, patients have been delaying their regular check-ups and the time to apply to the hospital has been prolonged.

Keywords:

COVID-19 , pandemic, breast cancer,

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London JW, Fazio-Eynullayeva E, Palchuk MB, Sankey P, McNair C. Effects of the COVID-19 Pandemic on Cancer-Related Patient Encounters. JCO Clin Cancer Inform. 2020 Jul;4:657-665. doi: 10.1200/CCI.20.00068.
Patt D, Gordan L, Diaz M, Okon T, Grady L et all. Impact of COVID-19 on Cancer Care: How the Pandemic Is Delaying Cancer Diagnosis and Treatment for American Seniors. JCO Clin Cancer Inform. 2020 Nov;4:1059-1071. doi: 10.1200/CCI.20.00134
Papautsky EL, Hamlish T. Patient-reported treatment delays in breast cancer care during the COVID-19 pandemic. Breast Cancer Res Treat. 2020 Nov;184(1):249-254. doi: 10.1007/s10549-020-05828-7.
American College of Radiology. American College of Radiology Breast Imaging Reporting and Data System Atlas (BI-RADS Atlas). American College of Radiology; 2013
Sinn HP, Kreipe H. A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition. Breast Care (Basel). 2013 May;8(2):149-54. doi: 10.1159/000350774
Malhotra A, Wu X, Fleishon HB, Duszak R Jr, Silva E 3rd et all. Initial Impact of COVID-19 on Radiology Practices: An ACR/RBMA Survey. J Am Coll Radiol. 2020 Nov;17(11):1525-1531. doi: 10.1016/j.jacr.2020.07.028.
Albano D, Bruno A, Bruno F, Calandri M, Caruso D et all. Young SIRM Working Group. Impact of coronavirus disease 2019 (COVID-19) emergency on Italian radiologists: a national survey. Eur Radiol. 2020 Dec;30(12):6635-6644. doi: 10.1007/s00330-020-07046-7.
Caplan L. Delay in breast cancer: implications for stage at diagnosis and survival. Front Public Health. 2014 Jul 29;2:87. doi: 10.3389/fpubh.2014.00087.
Vanni G, Pellicciaro M, Materazzo M, Bruno V, Oldani C et all. Lockdown of Breast Cancer Screening for COVID-19: Possible Scenario. In Vivo. 2020 Sep-Oct;34(5):3047-3053. doi: 10.21873/invivo.12139.
https://www.eusobi.org/news/recommendations-breast-covid19/