Changes In the Operative Management of Breast Cancer During The COVID Pandemic - Single Institution Experience

Abstract Aims COVID has had a wide ranging impact on surgical practice; including staffing issues, procedural prioritisation and changes to perioperative practice. We aim to compare the operative management of breast cancer before and during year 1 of the pandemic. Methods A retrospective review of primary breast cancer surgery in women between 23/3/2020–23/3/2021 with sub-analysis looking at wave 1 of COVID (23/3/2020–23/7/2020), compared to pre-COVID (1/1/2018–31/12/2018). Data collected include type and complexity of surgery, re-operations and complications. Results Pre-COVID, 606 cancers were included, with 217 (35.8%) simple BCS, 241(39.8%) oncoplastic BCS, 88 (14.5%) simple mastectomies and 60 (9.9%) mastectomies with immediate reconstruction. During COVID study period, a total of 398 cancers were included, with operative number (percentages) being 104(26.1%), 176(44.2%), 83(20.9%) and 35(8.8%) respectively. During wave 1, 47 cancers were diagnosed and operated on. The operative numbers (percentages) during initial wave COVID pandemic were 9 (19.1%), 25(53.2%), 12(25.5%) and 1(2.1%) respectively. Conclusions In our unit COVID led to a shift of breast cancer operative management to more BCS and simple mastectomies. As a unit, we were able to maintain good oncoplastic BCS service, however, reconstruction options were limited.