RELAÇÃO DA PANDEMIA DE COVID-19 NO ESTADIAMENTO AO DIAGNÓSTICO DE CÂNCER DE MAMA ENTRE AS MULHERES ATENDIDAS EM SERVIÇO DE REFERÊNCIA EM ONCOLOGIA DO VALE DO TAQUARI
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Data
2023-03
Autores
Orientador
Silva, André Anjos Da
Banca
Bucker, Joana
Dexheimer, Georgia Muccillo
Paskulin, Lívia D`Ávila
Título do periódico
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Título do Volume
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Resumo
O câncer de mama representa a neoplasia mais frequente e a principal causa de mortalidade entre as mulheres em todo o mundo. As opções terapêuticas e sobrevida estão diretamente relacionadas ao estágio da doença no momento do diagnóstico. O declínio significativo nos exames de rastreamento para o câncer de mama a partir março de 2020 devido às mudanças nas recomendações aos sistemas de saúde frente à pandemia de COVID-19 pode impactar negativamente nos números de diagnósticos precoces da doença.
Objetivo: comparar a distribuição do estágio ao diagnóstico de câncer de mama invasor durante a pandemia de COVID-19 (referindo-se aos diagnósticos entre 1º de janeiro de 2020 a 31 de março de 2022) com um controle histórico do período pré pandêmico (referindo-se aos diagnósticos entre 1º de janeiro de 2018 a 31 de dezembro de 2019).
Métodos: estudo observacional, transversal e retrospectivo no qual foram analisadas 127 mulheres com diagnóstico de carcinoma de mama invasivo confirmado por exame anatomopatológico, atendidas e tratadas em um centro de atendimento privado e de saúde suplementar de referência em oncologia do Vale do Taquari, no período de 1º de janeiro de 2018 a 31 de março de 2022. Excluíram-se indivíduos com idade inferior a 18 anos, pacientes do sexo masculino, diagnóstico de cânceres primários em outros sítios ou cânceres recidivados e indivíduos procedentes de municípios não pertencentes ao Vale do Taquari. A análise do qui-quadrado foi usada para comparar as distribuições no momento do diagnóstico.
Resultados: houve 57 pacientes diagnosticadas com câncer de mama na pré pandemia (2018-2019) e 70 pacientes durante a pandemia (2020-2022). A proporção de pacientes diagnosticadas com doença em estágio inicial reduziu durante a pandemia de COVID-19 (32% vs 28%; p=0.70) e aumentou a prevalência em estágio avançado (5% vs 13%; p=0,16), mas essa diferença não foi estatisticamente significativa em nenhum dos estágios clínicos. Houve ainda uma maior percentagem de pacientes diagnosticadas com o fenótipo triplo negativo durante a pandemia (4% vs 13%; p=0.04).
Conclusões: pacientes tinham maior probabilidade de serem diagnosticadas com câncer de mama em estágio avançado após o desligamento global devido à pandemia de COVID-19, especialmente no fenótipo triplo negativo. Esses dados levantam preocupações significativas em relação ao impacto da pandemia de COVID-19 nos diagnósticos de câncer e nos resultados de longo prazo, principalmente em subtipos histológicos com piores prognósticos.
Breast cancer represents the most frequent neoplasm and the main cause of mortality among women worldwide. Therapeutic options and survival are directly related to the stage of the disease at the time of diagnosis. The number of early diagnoses may be negatively impacted by the significant decline in screening tests for breast cancer from March 2020 due to changes in recommendations to health systems in the face of the COVID-19 pandemic. Objective: To compare the distribution of stage at diagnosis of invasive breast cancer during the COVID-19 pandemic (diagnoses between January 1, 2020 and March 31, 2022) with a historical control of the pre-pandemic period (diagnoses from January 1, 2018 to December 31, 2019). Methods: An observational, cross-sectional and retrospective study in which 127 women with a diagnosis of invasive breast cancer confirmed by anatomopathological examination were assisted and treated at a private and supplementary health care center of reference in oncology in Vale do Taquari, from January 1, 2018 to March 31, 2022. Patients younger than 18 years, male, diagnosed with primary cancers in other sites or recurrent cancers and individuals from cities outside Vale do Taquari were excluded. Chi-square analysis was used to compare distributions at diagnosis. Results: There were 57 patients diagnosed with breast cancer in the pre-pandemic (2018-2019) and 70 patients during the pandemic period (2020-2022). The proportion of patients diagnosed with early stage disease decreased during the COVID-19 pandemic (32% vs 28%; p=0.70) and increased in advanced stage prevalence (5% vs 13%; p=0.16), however this difference was not statistically significant in any of the clinical stages. There was still a higher percentage of patients diagnosed with the triple negative phenotype during the pandemic (4% vs 13%; p=0.04). Conclusions: Patients were more likely to be diagnosed with advanced breast cancer after the global shutdown due to the COVID-19 pandemic, especially the triple negative phenotype. These data raise significant concerns regarding the impact of the pandemic period on cancer diagnoses and long-term outcomes, mainly in histological subtypes with poorer prognoses.
Breast cancer represents the most frequent neoplasm and the main cause of mortality among women worldwide. Therapeutic options and survival are directly related to the stage of the disease at the time of diagnosis. The number of early diagnoses may be negatively impacted by the significant decline in screening tests for breast cancer from March 2020 due to changes in recommendations to health systems in the face of the COVID-19 pandemic. Objective: To compare the distribution of stage at diagnosis of invasive breast cancer during the COVID-19 pandemic (diagnoses between January 1, 2020 and March 31, 2022) with a historical control of the pre-pandemic period (diagnoses from January 1, 2018 to December 31, 2019). Methods: An observational, cross-sectional and retrospective study in which 127 women with a diagnosis of invasive breast cancer confirmed by anatomopathological examination were assisted and treated at a private and supplementary health care center of reference in oncology in Vale do Taquari, from January 1, 2018 to March 31, 2022. Patients younger than 18 years, male, diagnosed with primary cancers in other sites or recurrent cancers and individuals from cities outside Vale do Taquari were excluded. Chi-square analysis was used to compare distributions at diagnosis. Results: There were 57 patients diagnosed with breast cancer in the pre-pandemic (2018-2019) and 70 patients during the pandemic period (2020-2022). The proportion of patients diagnosed with early stage disease decreased during the COVID-19 pandemic (32% vs 28%; p=0.70) and increased in advanced stage prevalence (5% vs 13%; p=0.16), however this difference was not statistically significant in any of the clinical stages. There was still a higher percentage of patients diagnosed with the triple negative phenotype during the pandemic (4% vs 13%; p=0.04). Conclusions: Patients were more likely to be diagnosed with advanced breast cancer after the global shutdown due to the COVID-19 pandemic, especially the triple negative phenotype. These data raise significant concerns regarding the impact of the pandemic period on cancer diagnoses and long-term outcomes, mainly in histological subtypes with poorer prognoses.
Descrição
Palavras-chave
Câncer de Mama; COVID-19; Estadiamento; Pandemia; Breast Cancer; Staging; Pandemic
Citação
JEREMIAS, Camila Dagostim. RELAÇÃO DA PANDEMIA DE COVID-19 NO ESTADIAMENTO AO DIAGNÓSTICO DE CÂNCER DE MAMA ENTRE AS MULHERES ATENDIDAS EM SERVIÇO DE REFERÊNCIA EM ONCOLOGIA DO VALE DO TAQUARI. 2023. Tese (Mestrado) – Curso de Ciências Médicas, Universidade do Vale do Taquari - Univates, Lajeado, 22 mar. 2023. Disponível em: http://hdl.handle.net/10737/3892.