Abstract SS2-02: Patient perception of breast and gynecologic cancer care during the SARS-CoV-2 (COVID-19) pandemic in NYC: A single center survey-based study
Authors: Zimmerman Brittney S , Seidman Danielle , Berger Natalie , Cascetta Krystal P , Nezolosky Michelle , Trlica Kara , Ryncarz Alisa , Keeton Caitlin , Moshier Erin , Tiersten Amy 
Published: February 2021

Abstract
Background: The 2019 novel coronavirus has become a world-wide pandemic which has disproportionately affected patients undergoing treatment for cancer. Within the field of medical oncology, dramatic changes in practice patterns occurred rapidly to accommodate transition of resources, while maintaining safety of oncology patients. At our large cancer treatment center in NYC, there have been significant changes in the delivery of surgical and medical treatments, with a shift towards neo-adjuvant therapy, oral chemotherapy administration, extended ovarian suppression, as well as closure or delay of many clinical trials. This study aims to determine the impact of the COVID-19 pandemic on the perceived oncology related care of patients with breast/gynecologic cancers as measured by survey results, as well as the impact on quality of life (QOL) and overall health (OH). Methods: A 34-question survey was administered to all patients receiving care at our outpatient center between March 1, 2020 and June 30, 2020. Of the 622 patients who received the survey via RedCap online or physical copy in clinic, 211 (34%) completed the survey. Survey questions were answered on a 5-point Likert scale and 7-point EORTC QLQ-C30 QOL scale. There is no existing COVID specific questionnaire, therefore we designed several original questions. Difference in mean QOL scores prior to the pandemic and at the end of the response period were evaluated using a paired t-test. Results: Of the 184 patients who responded to the question about their diagnostic history, 54 (30%) of patients had a history of DCIS (ductal carcinoma in situ)/ADH (atypical ductal hyperplasia)/LCIS (lobular carcinoma in situ), 94 (51%) had a history of invasive breast cancer, 6 (3%) had a gynecologic malignancy and 30 (16%) responded “other.” Due to the COVID pandemic, 121 patients (58%) reported that they had a medical oncology visit cancelled, delayed or changed from in-person to video telehealth. Of the 156 respondents that had endocrine therapy or chemotherapy scheduled, 26 (17%) reported a cancellation or delay of their medical treatment. As a result of the pandemic, 186 (91%), 110 (57%) and 119 (60%) of patients reported new or increased levels of anxiety, depression and mood swings, respectively. A minority of patients (n=39, 19%) felt that the COVID pandemic negatively impacted their cancer care, and a majority (n=151, 73%) felt that the changes in delivering cancer care during the pandemic were in their best interest (somewhat/strongly agree). Overall, QOL was reported with a mean (SD) of 5.5 (1.3) out of 7 (1=very poor, 7-excellent) prior to the pandemic, and 5.1 (1.4) out of 7 by the end of the pandemic period (March 1 through June 30, 2020); p&lt;0.0001. Fifty-three (26%) of patients reported having excellent (7) QOL prior to pandemic which decreased to 32 (16%) after the pandemic period; p&lt;0.0001. Overall health was reported with a mean (SD) of 5.3 (1.3) out of 7 prior to the pandemic, and 5.1 (1.3) out of 7 by the end of the response period; p=0.0368. Conclusions: The COVID-19 pandemic required major changes in the care of patients with breast and gynecologic cancer in order to balance continued oncologic care with safety of COVID exposure. In our study population, 17% of patients at our center reported a delay or cancellation in their medical treatment and 58% reported a change to their medical oncology visits. Despite this, only 19% of all patients felt that the changes in care delivery as a result of the COVID-19 pandemic negatively impacted their cancer care, and the large majority (73%) felt that the changes were made in their best interest. The QOL for our patients was significantly affected by the pandemic, with increases in anxiety, depression and mood swings, and a numeric decrease in QOL and OH.
Citation Format: Brittney S Zimmerman, Danielle Seidman, Natalie Berger, Krystal P Cascetta, Michelle Nezolosky, Kara Trlica, Alisa Ryncarz, Caitlin Keeton, Erin Moshier, Amy Tiersten. Patient perception of breast and gynecologic cancer care during the SARS-CoV-2 (COVID-19) pandemic in NYC: A single center survey-based study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr SS2-02.