The impact of COVID-19 pandemic on breast surgery in Italy: a multi-centric retrospective observational study
By
R. Sgarzani
G. Macrì
A. Gurrado
A. Curcio
F. De Lorenzi
V. Galimberti
C. Garusi
M. Bocchiotti
M. Roncella
F. Rovera
G. Caputo
A. Sgarella
L. Barone Adesi
D. Terribile
R. Nonnis
P. Frittelli
B. Cagli
S. Tenna
I. Baldelli
A. Cordova
R. Elia
M. Salgarello
March 6, 2023
Clinical Scorecard: Effects of the COVID-19 Pandemic on Breast Surgery Practices in Italy: A Multi-Center Retrospective Study
At a Glance
Category Detail
Condition Breast cancer requiring surgical intervention Key Mechanisms COVID-19 pandemic caused healthcare resource reallocation, reduced surgical procedures, and altered breast surgery practices Target Population Patients undergoing breast cancer surgery in Italy during 2019 and 2020 Care Setting Italian Breast Care Units in hospitals not converted to COVID-19 centers
Key Highlights
Overall breast oncologic surgical procedures decreased by 9% in 2020 compared to 2019 (p < 0.01). Mastectomy rate increased significantly to 42% in 2020 from 39% in 2019 (p < 0.05), while breast-conserving surgery (BCS) decreased. Immediate direct-to-implant reconstructions increased by 15%, whereas expander reconstructions decreased by 20% in 2020 (p < 0.01). Guideline-Based Recommendations
Diagnosis
Maintain breast cancer diagnostic pathways despite pandemic constraints to avoid delays. Management
Prioritize surgical procedures based on urgency and resource availability during pandemic peaks. Consider increased use of direct-to-implant immediate reconstruction to reduce hospital stays and resource use. Monitoring & Follow-up
Monitor surgical volume trends and adjust resource allocation accordingly. Track mastectomy to BCS ratios to ensure balanced surgical care. Risks
Risk of delayed diagnosis and treatment due to reduced screening and patient hesitancy. Potential increase in more extensive surgeries (mastectomies) due to delayed presentations. Patient & Prescribing Data
Breast cancer patients undergoing surgery in Italy during 2019 and 2020
Surgical treatment shifted towards higher mastectomy rates and increased immediate direct-to-implant reconstructions during the COVID-19 pandemic.
Clinical Best Practices
Maintain breast cancer surgical services even during healthcare crises to minimize treatment delays. Adapt reconstructive techniques to optimize resource use and patient outcomes during pandemics. Use regional data to tailor surgical planning according to local pandemic impact. References
