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Delayed Breast Cancer Detection in an Asian Country (Taiwan) with Low COVID-19 IncidenceChen-Pin Chou et al. Cancer Manag Res. 2021.
. 2021 Jul 28:13:5899-5906. doi: 10.2147/CMAR.S314282. eCollection 2021. AffiliationsItem in Clipboard
AbstractPurpose: To assess whether the COVID-19 pandemic delayed breast cancer diagnosis in Taiwan, an Asian country with a low COVID-19 incidence.
Methods: The monthly volume of breast biopsies and breast cancers during the COVID-19 pandemic (during January 21 and July 31, 2020) was compared to the same period in 2019 (pre-COVID-19).
Results: Taiwan recorded a lower COVID-19 incidence rate (20.2 cases per million population) than other Asian countries. The screen-detected lesions accounted for 55% and 36% of 2019 and 2020 total biopsied lesions, respectively. Total breast biopsy, mammography-guided, and ultrasound-guided biopsies decreased by 17%, 23%, and 14%, respectively, from pre-COVID-19 to COVID-19. Monthly differences were significant in total biopsy (p=0.03), mammography-guided biopsy (p=0.04), and a benign pathology result after breast biopsy (p<0.01). Nearly 46% decline was noted in the biopsy results of non-invasive breast cancer in 2020. The number of total breast cancers and early breast cancers (stages 0 and 1) decreased by 10% and 38%, respectively, during pandemic. Individuals with early breast cancer accounted for 71% and 49% of the total diagnosed breast cancer in the pre-COVID-19 and COVID-19 periods, respectively (p<0.001).
Conclusion: The pandemic significantly delayed early breast cancer detection in Taiwan despite low COVID-19 incidence.
Clinical trial registration: ClinicalTrials.gov, NCT04750018.
Keywords: COVID-19; breast biopsy; breast cancer; mammography; pandemic.
© 2021 Chou and Lin.
Conflict of interest statementChen-Pin Chou and Huey-Shyan Lin have no conflict of interest.
FiguresFigure 1
Monthly trend in the number…
Figure 1
Monthly trend in the number of breast biopsy procedures and breast cancer cases…
Figure 1Monthly trend in the number of breast biopsy procedures and breast cancer cases in the periods of 2019 (Pre-COVID-19) and 2020 (COVID-19). A reference map shows a total number of confirmed COVID-19 cases (including imported and indigenous cases) in Taiwan by months.
Figure 2
Correlation between new monthly COVID-19…
Figure 2
Correlation between new monthly COVID-19 cases (N=466) and monthly difference of confirmed breast…
Figure 2Correlation between new monthly COVID-19 cases (N=466) and monthly difference of confirmed breast cancer cases between 2019 (N=128) and 2020 (N=115).
Figure 3
Percentage change of the number…
Figure 3
Percentage change of the number in breast cancer staging categories (stage 0–4) from…
Figure 3Percentage change of the number in breast cancer staging categories (stage 0–4) from pre-COVID-19 to COVID-19.
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