ArticleCureus2025
Impact of the COVID-19 Pandemic on Stage at Presentation Among Breast Cancer Patients: A Multicenter Retrospective Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Background Global healthcare systems were upended by the COVID-19 pandemic, which resulted in delayed cancer diagnosis and possible changes to disease staging at presentation. Objective The main objective of this study is to assess and compare the stage at which breast cancer patients presented before and during the COVID-19 pandemic, with particular attention to any shift toward more advanced stages at the time of diagnosis. Methodology This multicenter, retrospective, observational study was conducted at Shifa College of Medicine, Islamabad; Northwest School of Medicine, Peshawar; and Kabir Medical College, Peshawar. Excluding the peak lockdown period, female patients with new primary breast cancer diagnoses were split into two cohorts: pre-pandemic (March 2019-February 2020) and pandemic (September 2020-August 2021). There were 396 cases in total (204 pandemic and 192 pre-pandemic). Clinical, pathological, and temporal data were examined using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, NY, USA). Chi-square tests were used, and a p-value of less than 0.05 was deemed statistically significant. Results The number of patients receiving advanced-stage (Stage III-IV) diagnoses during the pandemic rose from 72 (37.50%) to 110 (53.92%), with Stage IV cases almost tripling from 17 (8.85%) to 33 (16.18%) (p < 0.05). Between Stage I and II, the number of early-stage patients decreased from 120 (62.50%) to 94 (46.08%). Treatment delays >60 days increased from 21 (10.94%) to 53 (25.78%), and diagnostic delays >60 days were more prevalent during the pandemic (75 patients, 36.76%) than before (51 patients, 26.56%). The average duration between diagnosis and therapy increased from 29.7 ± 14.8 to 42.3 ± 19.6 days, and from symptom onset to diagnosis, it increased from 47.6 ± 18.3 to 61.2 ± 21.5 days (p < 0.05). Conclusion The COVID-19 pandemic led to delayed diagnosis and a significant increase in advanced-stage breast cancer presentations in Pakistani women.
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