Abstract P1-05-22: The Impact of the COVID-19 Pandemic on Breast Cancer Diagnoses in San Antonio, TX
Authors: Souza Gabriel Roman , Aldawoodi Tamarah , Hussain Juzar , Jameson Lauren C. , Rahman Lauren , Agim Nomso C. , Gelfond Jonathan , Mazo-Canola Marcela 
Published: March 2023

Abstract
Introduction: Breast cancer is the most frequently diagnosed cancer and the second leading cause of cancer death in women in the United States. The significant advances in care over the last decades are largely attributable to early detection and treatment. The pre-COVID-19 pandemic 5-year survival rate of breast cancer was in the range of 90%, however, there has been public concern that the pandemic has led to delayed diagnosis. The objective of this study was to determine if patients diagnosed during the pandemic had more advanced breast cancer at presentation compared to those diagnosed prior.
Methods: This is a retrospective study of patients with an ICD code for Breast Cancer seen within the University of Texas Health San Antonio MD Anderson Cancer Center between 1/1/2018 and 12/31/2021. Data abstractors collected information on gender, age, race, ethnicity, funding, screening mammogram dates, date of cancer diagnosis, stage at diagnosis, and treatment. Those diagnosed before 1/1/2018 or that received initial treatment outside our institution were excluded from the analysis. Pearson’s Chi-squared and logistic regression tests were used to determine the relationship between time and stage at diagnosis. The timeline was divided into three periods: from 01/01/2018 to 03/31/2020 as the pre-COVID era, from 04/01/2020 to 12/31/2020 as the lockdown period, and from 01/01/2021 to the present as the post-vaccine era.
Results: A total of 696 patients with breast cancer were included. There was a significant statistical difference between the cancer stage at diagnosis in the pre-COVID-19 era compared to the lockdown period and the post-vaccine era (p= 0.003, table 1). Therefore, patients diagnosed after the beginning of lockdown were more likely to have more advanced cancer as time progressed. The odds ratio for Tis stage was 0.38 (95% CI: 0.23-0.60; P &lt; 0.001) in the post-vaccine era compared to the pre-COVID era. The OR for Tis stage was not statistically significant (OR, 0.68; 95% CI: 0.42-1.10; P &lt; 0.12) when comparing the lockdown period to the pre-COVID era.
Conclusion: Patients diagnosed with breast cancer in the COVID-19 pandemic were more likely to present with more advanced disease at diagnosis compared to those diagnosed in the pre-COVID-19 era confirming our hypothesis. The OR of presenting with Tis disease when diagnosed during the post-vaccine compared to the pre-COVID-19 era was 0.38, however, this was not seen when comparing the lockdown period to the pre-pandemic era. We believe this difference was not significant because delays in cancer care may take months to years to take full effect.
Table 1. Breast cancer stage at diagnosis per period.
Citation Format: Gabriel Roman Souza, Tamarah Aldawoodi, Juzar Hussain, Lauren C. Jameson, Lauren Rahman, Nomso C. Agim, Jonathan Gelfond, Marcela Mazo-Canola. The Impact of the COVID-19 Pandemic on Breast Cancer Diagnoses in San Antonio, TX [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-05-22.