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Purpose <p>To assess the long-term impact of the COVID-19 (C19) pandemic, we examined treatment patterns and delays in early-stage breast cancer (BC).</p> Methods <p>Patients ≥ 18&#xa0;years with clinical stage I–III BC diagnosed between 2019 and 2022 were identified in the National Cancer Database. Patients were categorized as pre-C19 (2019), early-C19 (2020), late-C19 (2021), and post-C19 (2022). Descriptive statistics assessed changes in early-stage BC treatment patterns and time-to-treatment initiation. Multivariable logistic regression was used to identify factors associated with treatment delays &gt; 60&#xa0;days.</p> Results <p>A decline in BC cases was observed during the pre- to early-C19 period, it was more pronounced among patients with stage I disease. While surgery as initial treatment decreased from pre- to post-C19, chemotherapy use increased. The early-C19 period was associated with lower odds of any treatment initiation delays &gt; 60&#xa0;days (adjusted odds ratio [aOR] = 0.87; 95% CI 0.85–0.89) while late-C19 (aOR = 1.20; 95% CI 1.17–1.22) and post-C19 (aOR = 1.46; 95% CI 1.43–1.49) were associated with higher odds compared to pre-C19. Black (aOR = 1.59; 95% CI 1.55–1.63) and Hispanic (aOR = 1.57; 95% CI 1.53–1.61) patients were more likely to have any treatment initiation delays.</p> Conclusions <p>The C19 pandemic disrupted BC care, contributing to ongoing treatment delays. Future studies are needed to understand how systemic factors impact long-term outcomes.</p>

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Patterns of care and treatment delays among patients with early-stage breast cancer: long term impact of the COVID-19 (C19) pandemic

  • 期刊论文

  • 发表日期：

    2025年11月1日

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  • Inimfon Jackson,
  • Marija Sullivan,
  • Xiudong Lei,
  • Sharon H. Giordano,
  • Mariana Chavez-MacGregor

摘要

Purpose

To assess the long-term impact of the COVID-19 (C19) pandemic, we examined treatment patterns and delays in early-stage breast cancer (BC).

Methods

Patients ≥ 18 years with clinical stage I–III BC diagnosed between 2019 and 2022 were identified in the National Cancer Database. Patients were categorized as pre-C19 (2019), early-C19 (2020), late-C19 (2021), and post-C19 (2022). Descriptive statistics assessed changes in early-stage BC treatment patterns and time-to-treatment initiation. Multivariable logistic regression was used to identify factors associated with treatment delays > 60 days.

Results

A decline in BC cases was observed during the pre- to early-C19 period, it was more pronounced among patients with stage I disease. While surgery as initial treatment decreased from pre- to post-C19, chemotherapy use increased. The early-C19 period was associated with lower odds of any treatment initiation delays > 60 days (adjusted odds ratio [aOR] = 0.87; 95% CI 0.85–0.89) while late-C19 (aOR = 1.20; 95% CI 1.17–1.22) and post-C19 (aOR = 1.46; 95% CI 1.43–1.49) were associated with higher odds compared to pre-C19. Black (aOR = 1.59; 95% CI 1.55–1.63) and Hispanic (aOR = 1.57; 95% CI 1.53–1.61) patients were more likely to have any treatment initiation delays.

Conclusions

The C19 pandemic disrupted BC care, contributing to ongoing treatment delays. Future studies are needed to understand how systemic factors impact long-term outcomes.