Effects of COVID-19 on mastectomy and breast reconstruction rates: A national surgical sample Journal Article
| Authors: | Rubenstein, R. N.; Stern, C. S.; Plotsker, E. L.; Haglich, K.; Tadros, A. B.; Mehrara, B. J.; Matros, E.; Nelson, J. A. |
| Article Title: | Effects of COVID-19 on mastectomy and breast reconstruction rates: A national surgical sample |
| Abstract: | Background: The COVID-19 pandemic profoundly impacted breast cancer treatment in 2020. Guidelines initially halted elective procedures, subsequently encouraging less invasive surgeries and restricting breast reconstruction options. We examined the effects of COVID-19 on oncologic breast surgery and reconstruction rates during the first year of the pandemic. Methods: Using the National Surgical Quality Improvement Program, we performed an observational examination of female surgical breast cancer patients from 2017 to 2020. We analyzed annual rates of lumpectomy, mastectomy (unilateral/contralateral prophylactic/bilateral prophylactic), and breast reconstruction (alloplastic/autologous) and compared 2019 and 2020 reconstruction cohorts to evaluate the effect of COVID-19. Results: From 2017 to 2020, 175 949 patients underwent lumpectomy or mastectomy with or without reconstruction. From 2019 to 2020, patient volume declined by 10.7%, unilateral mastectomy rates increased (70.5% to 71.9%, p = 0.003), and contralateral prophylactic mastectomy rates decreased. While overall reconstruction rates were unchanged, tissue expander reconstruction increased (64.0% to 68.4%, p < 0.001) and direct-to-implant and autologous reconstruction decreased. Outpatient alloplastic reconstruction increased (65.7% to 73.8%, p < 0.0001), and length of hospital stay decreased for all reconstruction patients (p < 0.0001). Conclusions: In 2020, there was a nearly 11% decline in breast cancer surgeries, comparable mastectomy and reconstruction rates, increased use of outpatient alloplastic reconstruction, and significantly reduced in-hospital time across all reconstruction types. © 2022 Wiley Periodicals LLC. |
| Keywords: | adult; cancer surgery; retrospective studies; major clinical study; cancer patient; breast cancer; mastectomy; cohort analysis; breast neoplasms; breast reconstruction; mammaplasty; retrospective study; length of stay; hospitalization; total quality management; breast tumor; intermethod comparison; outpatient; breast endoprosthesis; breast implants; epidemiology; observational study; longitudinal study; clinical examination; prevention and control; lumpectomy; tissue expander; prophylactic mastectomy; contralateral prophylactic mastectomy; demographics; pandemic; bilateral prophylactic mastectomy; procedures; autologous; unilateral mastectomy; humans; human; female; article; autologous breast reconstruction; direct-to-implant; patient volume; pandemics; coronavirus disease 2019; covid-19; alloplastic breast reconstruction |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 126 |
| Issue: | 2 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2022-08-01 |
| Start Page: | 205 |
| End Page: | 213 |
| Language: | English |
| DOI: | 10.1002/jso.26889 |
| PUBMED: | 35411946 |
| PROVIDER: | scopus |
| PMCID: | PMC9088456 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 August 2022 -- Source: Scopus |
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