The Impact of COVID-19 on breast oncology care practices during the pandemic in New York City: A single center retrospective study

Background: In early March of 2020, New York City (NYC) became the epicenter of the COVID-19 (SARS-CoV-2) pandemic in the United States. Early reports suggested that cancer patients who received chemotherapy prior to diagnosis with COVID-19 were at risk for more severe disease. In an effort to limit patient exposure to COVID-19, modifications to the delivery of cancer care were made at our large NYC outpatient practice. This study aimed to assess the impact of the COVID-19 pandemic on breast oncology practice patterns. Methods: Patients with appointments scheduled, postponed, or changed to virtual visits with medical oncology between March 1 and June 30, 2020 at our outpatient center were identified. Demographic and clinical data were abstracted through a review of the electronic medical record. Raw data from RedCap was preprocessed and analysis was performed in R statistical environment. Results: Records for 359 patients were reviewed. Median age was 59.6 and 98% were female. 305 (85%) were receiving systemic therapy at the time of review, with 181 (50.4%) receiving hormone therapy alone and 65 (18.1%) receiving chemotherapy. Of 319 patients receiving or planned to receive systemic therapy, 28 (8.8%) had treatment delayed. 58 patients (17.1%) had a change in their treatment plan, with the most common being extension of ovarian suppression to long-acting leuprolide administration (administered every 10 weeks) from monthly administration (N=23, 37.7% of patients with changes to their plan). 11 patients (18%) received neoadjuvant therapy with delay of surgery, 8 patients (13.1%) were treated with a different systemic therapy, 8 patients (13.1%) had systemic therapy held, and 4 patients (6.6%) were not offered any systemic therapy. Estradiol levels were checked among patients treated with long-acting leuprolide and 100% were found to be in the menopausal range. 116 of the 359 patients (32.3%) had telemedicine visits during the study period. Of all patients reviewed, 28 (7.8%) received diagnoses of COVID-19 during the study period. Eight of the 28 patients (28.6%) were asymptomatic, 16 (57.1%) had mild symptoms that did not require hospitalization, 2 (7.1%) required emergency room visits only, and 2 (7.1%) died from COVID-19 related illness. Conclusions: Among a large sample of breast oncology patients, the vast majority did not have any interruption or change to their treatment during the study period. The most common deviation from the standard of care was the use of longer acting leuprolide and estradiol levels remained in the menopausal range. While the long-term effects of the COVID-19 pandemic on the clinical outcomes of breast oncology patients are unknown, patients treated at our center received largely uninterrupted care. The COVID-19 infection rate among our patient population (7.8%) was significantly lower than the general infection rate in NYC during the same time period (20%). Citation Format: Danielle Seidman, Brittney S. Zimmerman, Lauren Margetich, Serena Tharakan, Natalie Berger, Rima Patel, Michelle Nezolosky, Himanshu Joshi, Krystal P. Cascetta, Amy Tiersten. The Impact of COVID-19 on breast oncology care practices during the pandemic in New York City: A single center retrospective study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 718.