Breast cancer survivorship care during the COVID-19 pandemic within an urban New York Hospital System

Allen Mo, Julie Chung, Jeremy Eichler, Sarah Yukelis, Sheldon Feldman, Jana Fox, Madhur Garg, Shalom Kalnicki, Nitin Ohri, Joseph A. Sparano, Jonathan Klein

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Purpose: To examine clinicodemographic determinants associated with breast cancer survivorship follow-up during COVID-19. Methods: We performed a retrospective, population-based cohort study including early stage (Stage I-II) breast cancer patients who underwent resection between 2006 and 2018 in a New York City hospital system. The primary outcome was oncologic follow-up prior to and during the COVID-19 pandemic. Secondary analyses compared differences in follow-up by COVID-19 case rates stratified by ZIP code. Results: A total of 2942 patients with early-stage breast cancer were available for analysis. 1588 (54%) of patients had attended follow-up in the year prior to the COVID-19 period but failed to continue to follow-up during the pandemic, either in-person or via telemedicine. 1242 (42%) patients attended a follow-up appointment during the COVID-19 pandemic. Compared with patients who did not present for follow-up during COVID-19, patients who continued their oncologic follow-up during the pandemic were younger (p = 0.049) more likely to have received adjuvant radiation therapy (p = 0.025), and have lower household income (p = 0.031) on multivariate modeling. When patients who live in Bronx, New York, were stratified by ZIP code, there was a modest negative association (r = −0.56) between COVID-19 cases and proportion of patients who continued to follow-up during the COVID-19 period. Conclusion: We observed a dramatic disruption in routine breast cancer follow-up during the COVID-19 pandemic. Providers and health systems should emphasize reintegrating patients who missed appointments during COVID-19 back into regular surveillance programs to avoid significant morbidity and mortality from missed breast cancer recurrences.

Original languageEnglish
Pages (from-to)301-307
Number of pages7
JournalBreast
Volume59
DOIs
StatePublished - Oct 2021

Keywords

  • Breast cancer
  • COVID-19
  • Cancer survivorship

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