Impact of the COVID-19 pandemic on surgical breast cancer care in the Netherlands: a multicentre retrospective cohort study.

Filipe, M.D.; van Deukeren, D.; Kip, M.; Doeksen, A.; Pronk, A.; Verheijen, P.M.; Heikens, J.T.; Witkamp, A.J.; Richir, M.C.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has put a strain on regular healthcare worldwide. In the Netherlands, the national screening programs, including breast cancer, were halted temporarily. This poses a challenge to breast cancer care, since approximately 40% of cases is detected through national screening. Therefore, the aim of this study is to evaluate the impact of the COVID-19 pandemic on surgical care of breast cancer patients in the Netherlands. METHODS: This multicenter retrospective cohort study investigated the impact of COVID-19 on breast cancer patients undergoing surgery from March 9(th) to May 17(th) 2020. Primary endpoints were the number of surgical procedures performed over time, tumor characteristics, type of surgery and route of referral. The secondary endpoint was the number postoperative complications over time. RESULTS: In total, 217 consecutive breast cancer patients requiring surgery were included. There was an overall decrease in the number of breast cancer patients undergoing surgical procedures. The most significant decline was seen in surgical procedures for T1-2 and N0 tumors. A decline in the number of referrals from both the national screening program and the general practitioners was observed. The number of postoperative complications remained stable over the study period. CONCLUSION: The temporary halt of the national screening program for breast cancer has resulted in fewer surgical procedures over time and a pronounced decrease in the lower tumor stages that were operated on.