Impact of COVID-19 on surgical treatment patterns in breast cancer: an Italian North-west tertiary referral breast unit analysis.

Abstract Purpose Oncological treatments experienced a significant reduction during COVID-19 pandemic. The aim of our retrospective study was to evaluate breast cancer surgical treatment modification during COVID. Methods We retrospectively evaluated the patients treated during 2019 and compared to those treated in 2020 according to surgery choice, stratified by quarter for each study year. Results surgical activity decreased from 890 cases in 2019 to 638 cases in 2020, referred to distribution stratified by radicality and plastic reconstruction surgery (p = 0.0019). Our analysis found a reduction in conservative surgery between 2019 and 2020. An increased trend in axillary dissections was observed (47% of interventions done in 2019 vs 53% in 2020). Similarly, the number of bilateral mastectomies increased in 2020 compared to 2019 with 16 vs 32 (p = 0.001). Conclusion we impute the decrease of surgical activities in 2020 compared to 2019 not only to a screening delay but also to an increased patients fear of hospital access for routinary diagnostic procedures or for symptoms check-up. Especially during pandemic, preference should be given to the most effective minimal surgical procedure, with the fastest recovery time, that lower risks for the individual patient and reduce the need of healthcare resources.