scholarly journals The impact of COVID-19 pandemic on the rate of newly diagnosed gynecological and breast cancers: a tertiary center perspective

2021 ◽  
Author(s):  
Katharina Knoll ◽  
Elisabeth Reiser ◽  
Katharina Leitner ◽  
Johanna Kögl ◽  
Christoph Ebner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Gynecological Cancer ◽  
Performance Status ◽  
Tumor Stage ◽  
Breast Cancers ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Tertiary Center ◽  
The Impact

Abstract Purpose The aim of the present study was to assess the impact of postponed screening examinations and lockdown measures on gynecological and breast cancer diagnoses throughout the year 2020 in a gynecological oncological center in Austria. Methods Data of 889 patients with either newly diagnosed gynecological or breast cancer between January 2019 and December 2020 were collected. Clinical parameters including symptoms, performance status, comorbidities and referral status were compared in patients, who were newly diagnosed with cancer in the period of the first lockdown from March 2020 to April 2020 and the second lockdown from November 2020 to December 2020 and compared to the same period in 2019. Results Our results showed a strong decline in newly diagnosed cancers during the lockdown periods: −45% in gynecological cancer and -52% in breast cancer compared to the same period in 2019. Compared to the analogue period of 2019, breast cancer patients reported significantly more tumor-associated symptoms (55% vs. 31%, p = 0.013) during and in between (48% vs. 32%, p = 0.022) the lockdowns. During the lockdown, periods in the group of breast cancer patients’ tumor stage varied significantly compared to 2019 (T2–T4; p = 0.047). Conclusion Both lockdowns led to a strong decrease in newly diagnosed gynecological and breast cancers. Treatment delays in potentially curable disease could lead to inferior clinical outcomes, with the risk of missing the optimal treatment window. As the COVID-19 pandemic will be a challenge for some time to come, new strategies in patient care are needed to optimize cancer screening and management during the pandemic.

scholarly journals The Impact of COVID-19 Pandemic on Gynecological and Breast Cancer Detection Rate: A Tertiary Center Perspective.

2021 ◽  
Author(s):  
Katharina Knoll ◽  
Elisabeth Reiser ◽  
Katharina Leitner ◽  
Johanna Kögl ◽  
Christoph Ebner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Detection ◽  
Detection Rate ◽  
Cancer Detection Rate ◽  
Breast Cancer Detection ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Tertiary Center ◽  
The Impact

Abstract Purpose: The aim of the present study was to assess the impact of postponed screening examinations and lockdown measures on gynecological and breast cancer detection rate throughout the year 2020 in a gynecological oncological center in Austria.Methods: Data of 889 patients with either newly diagnosed gynecological or breast cancer between January 2019 and December 2020 were collected. Clinical parameters including symptoms, performance status, comorbidities and referral status were compared in patients, who were newly diagnosed with cancer in the period of the first lockdown from March 2020 – April 2020 and the second lockdown from November 2020 – December 2020 and compared to the same period in 2019.Results: Our results showed a strong decline in newly diagnosed cancers during the lockdown periods: -45% in gynecological cancer and -52% in breast cancer compared to the same period in 2019. Compared to the analogue period of 2019, breast cancer patients reported significantly more tumor-associated symptoms (55% versus 31%, p=0.013) during and in between (48% versus 32%, p=0.022) the lockdowns. During the lockdown periods breast cancer patients were diagnosed with a significantly higher tumor-stage (T2-T4; p=0.047).Conclusion: Both lockdowns led to a strong decrease in newly diagnosed gynecological and breast cancers. Treatment delays in potentially curable disease could lead to inferior clinical outcomes, with the risk of missing the optimal treatment window. As the COVID-19 pandemic will be a challenge for some time to come, new strategies in patient care are needed to optimize cancer screening and management during the pandemic.

Recruiting breast cancer patients for mHealth research: Obstacles to clinic-based recruitment for a mobile phone app intervention study

2020 ◽  
Vol 17 (6) ◽  
pp. 675-683
Author(s):  
Alisha Gupta ◽  
Gabrielle Ocker ◽  
Philip I Chow
Keyword(s):  
Breast Cancer ◽  
Mental Health ◽  
Pilot Study ◽  
Cancer Patients ◽  
Large Scale ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Pilot Studies ◽  
Staff Members ◽  
The Impact

Background Nearly half of newly diagnosed breast cancer patients will report clinically significant symptoms of depression and/or anxiety within the first year of diagnosis. Research on the trajectory of distress in cancer patients suggests that targeting patients early in the diagnostic pathway could be particularly impactful. Given the recent rise of smartphone adoption, apps are a convenient and accessible platform from which to deliver mental health support; however, little research has examined their potential impact among newly diagnosed cancer patients. One reason is likely due to the obstacles associated with in-clinic recruitment of newly diagnosed cancer patients for mHealth pilot studies. Methods This article draws from our experiences of a recently completed pilot study to test a suite of mental health apps in newly diagnosed breast cancer patients. Recruitment strategies included in-clinic pamphlets, flyers, and direct communication with clinicians. Surgical oncologists and research staff members approached eligible patients after a medical appointment. Research team members met with patients to provide informed consent and review the study schedule. Results Four domains of in-clinic recruitment challenges emerged: (a) coordination with clinic staff, (b) perceived burden among breast cancer patients, (c) limitations regarding the adoption and use of technology, and (d) availability of resources. Potential solutions are provided for each challenge. Conclusion Recruitment of newly diagnosed cancer patients is a major challenge to conducting mobile intervention studies for researchers on a pilot-study budget. To realize the impact of mobile interventions for the most vulnerable cancer patient populations, health researchers must address barriers to in-clinic recruitment to provide vital preliminary data in proposals of large-scale research projects.

Impact of mammographic screening in staging, treatment and prognosis of breast cancer: Early assessment

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10537-10537
Author(s):  
A. Lluch ◽  
I. Chirivella ◽  
A. Insa ◽  
F. Martinez-Ruiz ◽  
A. Santaballa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Breast Conserving Surgery ◽  
Tumor Stage ◽  
Mammographic Screening ◽  
Invasive Breast Carcinoma ◽  
Breast Cancer Patients ◽  
Early Assessment ◽  
The Impact

10537 Background: The use of breast cancer mammographic screening (MS) leads to early detection and has been shown to reduce the mortality rate and to increase the proportion of breast-conserving surgery. The aim of this study is to analyze the impact of mammography in the staging, treatment and prognosis of breast carcinoma. Methods: In 1993, a population-based mammographic screening among women aged from 45 to 70 years was introduced in the community of Valencia. We examined the effects of this MS program by the comparison of two populations. The first one included all the women with screen-detected invasive breast carcinoma between 1993 and 2002 in the community of Valencia. The second one was comprised of all the women with invasive breast carcinoma, diagnosed in the same period, aged 45–70, not attending the MS and treated at H. Clinico of Valencia. Results: Between January, 1993 and December, 2002, 2313 new invasive breast cancer patients were detected by the MS program in the community of Valencia, and 1349 women aged 45–70, not attending de MS were diagnosed with invasive breast carcinoma in H.Clinico of Valencia. The median follow-up period was 45.5 months for the screen-detected breast cancer and 51.9 months for not screen-detected patients. The screen-detected tumors had smaller pathological size (pT1 tumors 70.2% vs 40.5%, p < 0.0001), were more likely to have pathologically confirmed negative nodal status (66.4% vs 52.2%, p < 0.0001) and stage I disease (55.3% vs 26.1%, p < 0.0001). Breast-conserving surgery was performed in 50.4% of patients with screen-detected tumors and in 31.9% of women who had not undergone MS (p < 0.0001). The 5-year estimated survival was 95.5% (SE 0.57) for women with screen-detected breast cancer and 85.5% (SE 1.17) for those with not screen-detected tumors (p < 0.0001). Conclusions: Our data demonstrate a better prognosis in terms of 5-year survival in screen-detected breast cancer patients that may explain why breast carcinoma mortality rates have decreased in recent decades. These patients have also been found to have smaller tumors, a more favorable tumor stage and a higher proportion of breast-conserving surgery. No significant financial relationships to disclose.

MRI versus breast-specific gamma imaging (BSGI) in the detection of synchronous breast cancer: A prospective head-to-head trial.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 72-72
Author(s):  
L. J. Kirstein ◽  
J. L. Keto ◽  
D. P. Sanchez ◽  
T. Fulop ◽  
I. Cohen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Imaging Study ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancers ◽  
Imaging Findings ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Significant Difference

72 Background: Literature suggests that MRI identifies additional mammographically and sonographically occult cancers in 8-10% of newly diagnosed breast cancer patients. We have reported comparable sensitivity of BSGI to MRI in the detection of the known index cancer. We sought to prospectively compare BSGI to MRI in the identification of additional occult malignancies in newly diagnosed breast cancer patients. Methods: Patients with newly diagnosed breast cancer from June 1, 2009 through February 4, 2011 were consented for an IRB approved protocol in which they underwent both breast MRI and BSGI. Each imaging study was read by a dedicated breast radiologist, with one reading all MRI, and another reading all BSGI studies. All subsequent biopsies were performed percutaneously under image guidance and reviewed by dedicated pathologists. The identification of additional occult breast cancers by MRI and BSGI was compared. Results: Eighty-five patients underwent both MRI and BSGI. Twenty-one patients elected to undergo mastectomy without further management of imaging findings and were excluded, leaving 64 eligible patients. No additional lesions were found in 22 patients. Twenty-one patients had benign pathology on biopsied imaging findings. Metastatic axillary lymph nodes, satellite lesions or larger extent of disease was identified in 11 patients. Eleven occult breast cancers were identified in 10 patients (15.6%), 6 on MRI alone (9.4%), 3 on BSGI alone (4.7%), and 2 by both modalities (3.1%). There was no significant difference in the identification of occult cancer between MRI and BSGI (chi-square 0.77, p>0.1; Table). Conclusions: BSGI has previously been shown to be as sensitive as MRI for detecting known invasive and in situ breast carcinoma. This study shows that BSGI is equally sensitive to MRI in the detection of synchronous mammographically and sonographically occult cancers in newly diagnosed breast cancer patients. Further research is needed to identify the false positive rates of BSGI and the effect on surgical management in comparison to MRI. [Table: see text]

scholarly journals Decrease in gynecological cancer diagnoses during the COVID-19 pandemic: an Austrian perspective

2020 ◽  
Vol 30 (11) ◽  
pp. 1667-1671
Author(s):  
Irina Tsibulak ◽  
Elisabeth Reiser ◽  
Gerhard Bogner ◽  
Edgar Petru ◽  
Johanna Hell-Teutsch ◽  
...  
Keyword(s):  
Gynecological Cancer ◽  
Performance Status ◽  
Breast Cancers ◽  
Newly Diagnosed ◽  
Before And After ◽  
Bed Capacity ◽  
Referral Status ◽  
Specific Symptoms ◽  
The Impact ◽  
Patient Referrals

BackgroundOn March 16, 2020, the federal government of Austria declared a nationwide lockdown due to the COVID-19 pandemic. Since the lockdown, screening examinations and routine checkups have been restricted to prevent the spread of the virus and to increase the hospitals’ bed capacity across the country. This resulted in a severe decline of patient referrals to the hospitals.ObjectiveTo assess the impact of the COVID-19 pandemic on the rate of newly diagnosed gynecological and breast cancers in Austria.MethodsData of 2077 patients from 18 centers in Austria with newly diagnosed gynecological or breast cancer between January and May 2019 and January and May 2020 were collected. Clinical parameters, including symptoms, performance status, co-morbidities, and referral status, were compared between the time before and after the COVID-19 outbreak.ResultsOur results showed a slight increase of newly diagnosed cancers in January and February 2020 as compared with 2019 (+2 and +35%, respectively) and a strong decline in newly diagnosed tumors since the lockdown: −24% in March 2020 versus March 2019, −49% in April 2020 versus April 2019, −49% in May 2020 versus May 2019. Two-thirds of patients diagnosed during the pandemic presented with tumor-specific symptoms compared with less than 50% before the pandemic (p<0.001). Moreover, almost 50% of patients in 2020 had no co-morbidities compared with 35% in 2019 (p<0.001). Patients, who already had a malignant disease, were rarely diagnosed with a new cancer in 2020 as compared with 2019 (11% vs 6%; p<0.001).ConclusionsThe lockdown led to a decreased number of newly diagnosed gynecological and breast cancers. The decreased accessibility of the medical services and postponed diagnosis of potentially curable cancers during the COVID-19 pandemic may be a step backwards in our healthcare system and might impair cancer treatment outcomes. Therefore, new strategies to manage early cancer detection are needed to optimize cancer care in a time of pandemic in the future.

scholarly journals Are Thyroid Hormone and Tumor Cell Proliferation in Human Breast Cancers Positive for HER2 Associated?

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Iordanis Mourouzis ◽  
Alexandros Tzovaras ◽  
Basil Armonis ◽  
Alexandros Ardavanis ◽  
Maria Skondra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cell Proliferation ◽  
Thyroid Hormone ◽  
Cancer Patients ◽  
Breast Cancers ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Normal Range ◽  
Her2 Breast Cancer ◽  
Er Positive

Objective.This study investigated whether thyroid hormone (TH) levels are correlated to cell proliferation (Ki67), in euthyroid breast cancer patients.Design and Methods.86 newly diagnosed breast cancer patients with estrogen receptor (ER) positive tumors, who referred for surgery, were included in the study.Results.FT3, FT4, and TSH were within normal range. No correlation was seen between Ki67 and FT3 (r=-0.17,P=0.15), FT4 (r=-0.13,P=0.25), or TSH (r=-0.10,P=0.39) in all patients studied. However, subgroup analysis showed that, in HER2(+) patients, a negative correlation existed between FT3 levels and Ki67 (r=-0.60andP=0.004) but not between Ki67 and FT4 (r=0.04andP=0.85) or TSH (r=-0.23andP=0.30). In HER2(−) patients, there was no significant correlation between Ki67 and FT3 (r=-0.06,P=0.67), FT4 (r=-0.15,P=0.26), or TSH (r=-0.09,P=0.49). Phospho-p44/total p44 ERK levels were found to be increased by 2-fold in HER2(+) versus HER2(−) tumors. No difference was detected in phospho-p42/total p42 ERK levels.Conclusions.TH profile is not altered in patients with newly diagnosed breast cancer. However, FT3 levels, even within normal range, are negatively correlated with cell proliferation in HER2(+) breast cancer tumors. This response may be due to the interaction between ERK and TH signaling.

Impact ofBRCA1/BRCA2Counseling and Testing on Newly Diagnosed Breast Cancer Patients

2004 ◽  
Vol 22 (10) ◽  
pp. 1823-1829 ◽  
Author(s):  
Marc D. Schwartz ◽  
Caryn Lerman ◽  
Barbara Brogan ◽  
Beth N. Peshkin ◽  
Chanita Hughes Halbert ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Genetic Counseling ◽  
High Risk ◽  
Cancer Patients ◽  
Bilateral Mastectomy ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Surgical Decision ◽  
The Impact

PurposeApproximately 5% to 10% of newly diagnosed breast cancer patients carry a BRCA1 or BRCA2 mutation. Given these patients' high risk for contralateral breast cancer, bilateral mastectomy is increasingly considered a treatment option for newly diagnosed BRCA1/2 carriers. In the present study, we prospectively evaluated the impact on surgical decision-making of pretreatment genetic counseling and BRCA1/BRCA2 testing among breast cancer patients at high-risk for carrying a mutation.Patients and MethodsParticipants were 194 newly diagnosed breast cancer patients who had not yet received definitive surgical treatment and who had at least a 10% prior probability of carrying a BRCA1/2 mutation. Participants were offered free genetic counseling and rapid BRCA1/2 testing. Primary analyses focused on the impact of BRCA1/2 test result on subsequent breast cancer surgical treatment.ResultsForty-eight percent of patients who were found to carry a BRCA1/2 mutation chose bilateral mastectomy as their definitive breast cancer surgery. In contrast, 24% of patients in whom no mutation was detected and 4% of test decliners opted for bilateral mastectomy. Additional predictors of bilateral mastectomy included patients' self-reports of physician recommendations for BRCA1/2 testing and bilateral mastectomy.ConclusionThis study highlights patient interest in and the technical feasibility of offering presurgery BRCA1/2 testing to high-risk patients. Most importantly, these results demonstrate that BRCA1/2 test results significantly affect patients' surgical decision-making. The availability of genetic counseling and testing could serve as a valuable aid to patient decision-making for newly diagnosed breast cancer patients at high-risk for carrying a mutation.

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