7 - ARE BREAST CANCER PATIENTS PRESENTING WITH HIGHER STAGE SINCE THE COVID-19 PANDEMIC?

Objectives: The impacts of the COVID-19 pandemic have been far reaching in many aspects of healthcare, particularly oncologic detection and cancer care. As much of the progress in reducing morbidity and mortality related to breast cancer have resulted from screening and public health measures, we analyzed the stage at which patients with breast cancer presented for surgery from 2019 to 2021.

Methods: From 2019-2021, retrospective analysis was performed on breast cancer patients, comparing differences in patient demographics and cancer stage pre- and post- recommendation to postpone mammographic screening on March 26, 2020 (pre- vs. Covid-era). Proportion analysis was performed to identify similar percentages for each stage and a weighed stage severity score with sign test was crafted to compare overall stage for a given timeframe.

Results: Overall, 1,107 breast cancer patients were included in the breast cancer surgery registry. Four hundred and forty-nine patients were included in the pre-pandemic phase from 2019 to March 26, 2020 and 658 patients since the COVID pandemic era from March 26, 2020 to 2021.These groups were similar demographically; the average age was 63 in pre- and 61 in the COVID-era. The majority of patients were female pre- 99.6% and 99.5% Covid-era. In both groups, the majority of patients were white, non-Hispanics 78.2% pre- vs. 79% COVID-era, 19.7% black patients pre- vs. 18.8% COVID-era, 1.36% Asian/other patients in pre- vs. 1.12% COVID-era, 1.0% white, Hispanic patients pre- vs.0.89% COVID-era. We performed analysis comparing pre- COVID and COVID-era stage severity score. This showed a statistically higher stage presentation of disease when comparing pre-COVID to COVID-era data (p=0.0027). Additionally, we identified a higher rate of stage 3 disease presentation or greater in the COVID-era with 7.79% pre- vs. 12.3% COVID-era (p=0.016). However, we did not identify a difference in DCIS rates pre- vs. COVID-era, 17.5% vs 14.7% (p=0.28).

Conclusion: We found that in comparing pre- to COVID-era data that breast cancer patients presented with higher stages, in particular, stage 3 or more disease. This analysis reveals the impact COVID is having on the multidisciplinary treatment of breast cancer patients. Further efforts are needed to address the stage migration, the disproportionate burden of disease, and the access to care.