Impact of COVID-19 on Breast Cancer Treatment: A Tertiary Referral Centre Experience

Author(s): Kirsty Balachandran, Jennet Williams, David Bell, Anna Brown, Phawan Hurhangee, Rathi Ramakrishnan, Susan Cleator, Raoul Charles Coombes, Olivia Hatcher, Farah Rehman, Justin Stebbing, Laura Kenny

Background: The effect of the COVID-19 on breast cancer treatment is unknown. The pandemic’s impact on treatment delivery was assessed in patients undergoing chemotherapy treatment at a major London oncology centre.

Methods: Treatment and medical records for all patients attending the chemotherapy unit and on outpatient treatment for breast cancer over an 8 week period (during first lockdown; 23rd March-17th May 2020) were compared to a similar time period in 2019.

Results: Breast cancer diagnosis referrals fell by 38% mainly due to screening services halting which had a knock-on effect on patient numbers starting their first treatment (reduced by 34%). Neoadjuvant, adjuvant, and palliative patients were all affected, mostly at the start of lockdown. On-site chemotherapy and supportive treatments fell by 39% compared to 2019, mainly due to fewer number of bone-modifying agents. Towards the end of 8 week period, treatment numbers had nearly returned to normal. The system adapted by modifying treatment regimens, using telemedicine, increased use of supportive medications and less frequent blood tests.

Conclusion: COVID-19’s global impact has significantly reduced breast cancer treatments given during the first lockdown. Whilst recovery is now evident, cancer services, patients, and clinical cancer research must be prioritised in future waves.