The impact of the COVID-19 pandemic on the clinical and pathological stages of the patients diagnosed with breast cancer

After approval of ethical committee dated 15.12.2021; Covid-19 pre-pandemic a one-year term with the Covid-19 pandemic in the period of a one-year period within demographic data of patients who received a diagnosis of breast cancer, tumor size, axillary lymph node positivity, the status of distant metastases, the status of neoadjuvant chemotherapy, type of surgery, hormone receptor status, USG findings, stage of disease, tumor markers, Ki-67 proliferation index, histological part to remove the C-Erb-B2 positive parameters such as status were compared. A total of 298 patients over the age of 18, male and female, who were diagnosed with breast cancer at the General Surgery Clinic of Gaziantep University Faculty of Medicine and continued their surgical and oncological treatment at our center, were enrolled in our retrospective study. The registered data of the patients in the archives and hospital database belonging to the Department of General Surgery of the Faculty of Medicine of Gaziantep University were examined. The data were compared as 1 year period (10.03.2019-10.03.2020) prior to the date of the first COVID-19 case on 11.03.2020 and 1 year period (11.03.2020-11.03.2021) from the date of the first case on 11.03.2020. The data were analyzed by IBM SPSS.23 (IBM Inc., Chicago, IL, USA) program. Of the cases included in the study, 186 (62.4%) were patients admitted before the pandemic and 112 (37.6%) were patients admitted during the pandemic period. Of the patients, 295 (99.0%) were female and 3 (1.0%) were male. The mean age of the patients was 53.45±11.88. There was no significant difference between the periods in terms of gender and average age. Of the 298 patients diagnosed with breast cancer, 186 (62.4%) were patients belonging to the pre-Covid period and 112 (37.6%) were patients belonging to the Covid period. It was found that there was a 39.7% decrease in the number of people diagnosed with breast cancer in accordance with the literature. Family history was present in 25 (13.4%) of the patients before the pandemic period and in 4 (3.6%) of the patients during the Covid period. It was found that there was a statistically significant relationship between family history and Covid (p=0.005). Smoking was observed in 55 of the patients (29.6%) before the pandemic period and in 14 of the patients (12.5%) during the Covid-19 period. It was observed that smoking decreased during the Covid-19 period and this was statistically significant (p=0.001). The histopathological grade of 50 (26.9%) of the patients before Covid and 41 (36.6%) of the patients during Covid was 3. It was found that this increase was statistically significant in terms of histopathological grade (p=0.018). It was observed that there was an increase in the disease stages of patients during the Covid period compared to the pre-Covid period. In this respect, a statistically significant difference was found between the pre-Covid and Covid periods(p=0.035). When the Covid period was compared with the pre-Covid period, it was found that there was a statistically significant relationship between the types of surgery. While Breast Conserving Surgery rates were high before the pandemic, it was observed that rates decreased during the pandemic period and were replaced by Simple Mastectomy and Modified Radical Mastectomy (MRM) (p<0.001). It was found that C-ERB-B2 ovarian expression also increased statistically significantly during the pandemic period (p=0.047).It was found that tumor size (T), axillary lymph node metastasis rate, neoadjuvant chemotherapy rate and distant metastasis rate increased during the pandemic period, but there was no statistically significant difference. (respectively; p=0.535, p=0.070, p=0.148, p=0.153) In our study, no significant differences were found between the tumor type, Ki-67 proliferation indices, hormone receptor between the two periods. In epidemic situations such as COVID-19, the duration of patients' admission to the hospital may be prolonged due to restrictions in social life and fear of transmission. This condition can cause delays in the diagnosis of malignant diseases such as breast cancer and worsening of the disease stage. In this and similar epidemic situations, public awareness should be raised and encouraged to comply with screening and follow-up programs in order to continue outpatient clinic activities and screening programs without interruption by taking personal protection measures. Keywords: Breast Cancer, COVID-19 Pandemic, Tumor Stage, Tumor Size, Smoking