1. Breast cancer survivorship care during the COVID-19 pandemic within an urban New York Hospital System.
- Author
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Mo A, Chung J, Eichler J, Yukelis S, Feldman S, Fox J, Garg M, Kalnicki S, Ohri N, Sparano JA, and Klein J
- Subjects
- Adolescent, Adult, Aged, Breast Neoplasms drug therapy, COVID-19 epidemiology, Cohort Studies, Female, Hospitals, Urban, Humans, Mastectomy, Middle Aged, Neoplasm Recurrence, Local, New York City epidemiology, Pandemics, Retrospective Studies, SARS-CoV-2, Young Adult, Breast Neoplasms mortality, COVID-19 psychology, Cancer Survivors psychology, Survivorship
- 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., Competing Interests: Declaration of competing interest NO is a consultant for Merck and AstraZeneca. There are no additional conflicts of interests to disclose., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2021
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