Delayed Breast Cancer Detection in an Asian Country (Taiwan) with Low COVID-19 Incidence

Chen-Pin Chou, Huey-Shyan Lin, Chen-Pin Chou, Huey-Shyan Lin

Abstract

Purpose: 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.

Conflict of interest statement

Chen-Pin Chou and Huey-Shyan Lin have no conflict of interest.

© 2021 Chou and Lin.

Figures

Figure 1
Figure 1
Monthly 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
Figure 2
Correlation 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
Figure 3
Percentage change of the number in breast cancer staging categories (stage 0–4) from pre-COVID-19 to COVID-19.

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Source: PubMed

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