What happens when breast health is disrupted?

The world had no idea of the devastation the COVID-19 pandemic would unleash.
COVID-19 has resulted in a public health and economic crisis.

It has disrupted lives, pushed hospital systems to capacity, and created a global economic slowdown.
But perhaps what is lesser-known is the effect the pandemic has had on breast cancer patients. During the early months of the pandemic, screenings for breast cancer slowed as health care facilities tried to preserve resources for COVID-19 patients and reduce exposure to the virus.

A drastic decrease in breast cancer screenings

The American Cancer Society indicated its concern about the impact of the more than 22 million missed or delayed cancer screenings between March and June of 2020 due to COVID-19.

The total number of cancer screening tests received by women through CDC’s National Breast and Cervical Cancer Early Detection Program (Early Detection Program) declined by a massive 87% for breast cancer during April 2020, compared with the previous five years averages for that month.

Breast screenings decreased by 84% in Hispanic women and 98% in American Indian/Alaskan Native women. Regionally, the number of screening tests for breast cancer declined in metro (86%), urban (88%), and rural (89%) areas compared to the respective five-year averages.

What is the impact of this?

Wisconsin researchers carried out a study to predict how disruptions in the first six months of the pandemic would affect future breast cancer death numbers. Three independently developed breast cancer simulation models, developed by the U.S. National Cancer Institute’s Cancer Intervention and Surveillance Modeling Network, were used. The data was sourced from the Epic Health Research Network, from 60 health care organizations representing 10 million women from 306 hospitals across 28 states.

The research suggests that the number of excess breast cancer deaths due to the COVID-19 pandemic’s impact on screening, diagnosis and chemotherapy treatment could reach 2,487 over the next decade, including:

  • 950 additional breast cancer deaths related to reduced screening
  • 1,314 additional deaths associated with delayed diagnosis of symptomatic cases
  • 151 additional deaths due to reduced chemotherapy use in women with early-stage breast cancer

The Journal of the National Cancer Institute predicts a 0.52% increase in breast cancer deaths between 2020 and 2030.

What is very clear is that regular screening and early detection of breast cancer can result in a favorable prognosis for the cure and survival of the disease.

What about the delay in breast cancer care?

While breast cancer screening took a considerable dip due to COVID-19, breast cancer care, including mastectomies and breast reconstruction surgeries, was also adversely affected by the pandemic. The time between diagnosis and mastectomy and breast reconstruction is critical, with studies showing that delaying breast cancer surgery can lower survival rates.

Olive, an automation company creating the Internet of Healthcare, analyzed data from 27 hospitals across 19 counties to see how COVID-19 case levels affected the timing of mastectomies and breast reconstruction surgeries and how quickly hospitals returned to pre-pandemic volumes. Their research found a 58% decline in breast cancer surgeries from the same time last year.

Much of the decline was expected due to policies postponing “elective” care over concerns about hospital capacity and COVID-19 transmission. All facilities allowed non-emergent care by May 2020. The sustained dip in surgical volumes is also potentially due to lower demand due to the screening decline, patient wariness to undergo surgery in a pandemic, and/or limited hospital capacity and resource constraints.

The effect of the pandemic on breast cancer surgeries has become very apparent. In November 2020, hospitals in counties with low spread saw breast cancer surgery volumes remain over 100% of their pre-COVID level, while hospitals in high-spread areas only reached 66% of pre-COVID surgery volume in December 2020.

How can we increase the early detection of breast cancer?

Doctors are urging all women who skipped their mammogram or other form of breast cancer screening during the pandemic, to go for a screening as soon as possible. That’s the primary means of undoing the impact of the pandemic.

A new approach to breast screening, potentially saving millions of lives globally

Our main reason for developing Celbrea® is to increase early detection of breast cancer, as the earlier you detect any breast disease, the better your chances of recovery are.

The device does not replace a mammogram but simply provides an additional way to screen for breast disease. It aims to add to doctors’ existing standard evaluation protocols with a quick, painless examination.

Celbrea® aims to deliver a safe, effective, non-invasive, and easy-to-use technology to support routine physical breast examination. The device strives to broaden access to breast care worldwide by empowering women to monitor their breast health.

Without a doubt, healthcare looks very different than it did just a few short years ago. The  COVID-19 crisis has created a distinct “before” and “after” period for the world, especially for healthcare. And, while things may look like they’re slowly creeping back to “normal”, the actual effects of the pandemic on breast cancer patients will only become more obvious in the next five to ten years.

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