Dados do Trabalho

Título

IMPACTO DA PANDEMIA DA COVID-19 NO TAMANHO DO CÂNCER DE MAMA AO DIAGNÓSTICO

Título em Inglês

IMPACT OF COVID-19 ON BREAST CANCER TUMOR SIZE AT DIAGNOSIS

Introdução

In 2020, COVID-19 affected the whole world, determining the pandemic situation, with recommendations for social isolation and lockdown. In São Paulo state, the shut down of non-essential services was determined on March 22, 2020. Medical appointments and routine imaging exams were postponed and little is known about the impact on screening delay and the diagnosis of neoplasms. Considering that the survival and cure of breast cancer are directly related to early diagnosis, the size of these malignant tumors can be used in the research of the delay of breast cancer diagnosis.

Objetivos

To evaluate the impact of the pandemic on the size of breast cancer on histological diagnosis, as well as on the number of diagnostic procedures performed at our hospital.

Métodos

Through a retrospective, analytical and cross-sectional study, we analyzed data regarding tumors with histological results of malignancy of core needle breast biopsies guided by ultrasound performed at a private hospital in São Paulo between January 1, 2019 and December 31, 2020. The mean tumor sizes were compared to identify differences between prepandemic and pandemic periods. The prepandemic period (PRE) was established between January 1, 2019 and March 31, 2020 and the pandemic period (PAN) was considered from April 1 to December 31, 2020. Based on the sample size, this study has the power of 80% to detect variation of 1 cm in the mean tumor size.

Resultados

A total of 493 core needle biopsies were identified in 443 patients. A total of 103 (20.1%) biopsies in 94 patients were malignant. In the PAN group, 36 cancers were diagnosed (4 cases/month), while the PRE group was diagnosed with 67 cases (4.5 cases/month). The mean size of PRE tumors was 1.66 cm, while PAN was 2.21, with a difference of 0.55 cm without statistical significance (95%CI: 0.12 - 1.21; p=0.12). When considering staging (TNM), the stages T1, T2 and T3 had no significant difference among the groups (p=0.12). The age of diagnosis of malignant lesion ranged from 30 to 82 years in the PRE period, and 34 to 85 years in the PAN period. The mean age of patients with malignant lesions diagnosed in PAN higher than PRE, without statistical significance (59.2 vs 56.0; p=0.30). Despite the fewer biopsies performed in both periods, (p<0.001), there was no statistical difference in the number of biopsies with malignant results (p=0.18), since there were proportionally more diagnoses of malignancy in the PAN period (28.6% vs. 18.3%; RR 1.14; IC95% 1.01 - 1.29; p=0.02).

Conclusões

Although the pandemic affected breast cancer screening, there is no statistically significant increase in the mean size of cancers diagnosed in this service has been identified so far.

Palavras Chave

breast neoplasms, core needle biopsy, coronavirus infection

Área

DETECTION / DIAGNOSIS - Breast lesion