The impact of the COVID-19 pandemic on symptomatic breast cancer presentations in an Irish breast cancer unit - a retrospective cohort study

Sep 21, 2026

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The study assesses how the COVID-19 pandemic affected symptomatic breast cancer presentations in an Irish breast cancer unit. A retrospective chart review compared patients diagnosed with invasive symptomatic breast cancer in 2019 (pre-pandemic) versus 2020–2022 (pandemic). Across 1416 patients, new metastatic presentations increased significantly in 2022 versus 2019, while adjuvant radiotherapy and axillary surgery patterns shifted during the pandemic. Tumours showed higher-grade features, more lymphovascular invasion, and reduced oestrogen receptor positivity. Despite stable BCS-to-mastectomy ratios, nodal positivity and median tumour size did not change significantly.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Introduction

Pandemic-related service disruptions

Evidence gaps and rationale

Study aim and objectives

Irish Journal of Medical Science (1971-) (2024) 193:1763–1772 [https://doi.org/10.1007/s1](https://doi.org/10.1007/s1) 1845-024-03688-4 The impact of the COVID‑19 pandemic on symptomatic breast cancer presentations in an Irish breast cancer unit: a retrospective cohort study Áine Higgins1 · Seamus O’Reilly2 · Martin J. O’Sullivan3 Received: 18 January 2024 / Accepted: 12 April 2024 / Published online: 19 April 2024 © The Author(s) 2024 Abstract Background The coronavirus-19 (COVID-19) pandemic caused delays in the diagnosis and management of breast cancer which may have affected disease presentation. The aim of this study was to compare rates of metastatic disease, tumour characteristics and management in breast cancer patients diagnosed before and after the onset of COVID-19 . Methods A retrospective chart review was conducted on patients in a university teaching hospital who were diagnosed with invasive symptomatic breast cancer in 2019 (prepandemic control group) and in 2020, 2021, and 2022 (pandemic study groups) . Rates of new metastatic presentations, tumour histopathological characteristics, operation type, and therapies administered were statistically compared. Results A total of 1416 patients were identified. There was a significant increase in new metastatic breast cancer presentations in 2022 compared to 2019 (14.0% vs 3.8%, p ≤ 0.001), with non-significant increases in 2020 and 2021. Rates of adjuvant radiotherapy increased in 2020 and decreased in 2022 compared to 2019, with no significant change in neoadjuvant oradjuvant chemotherapy rates. Rates of axillary surgery increased during 2020 and 2021. There was an increase in high-grade tumours and lymphovascular invasion (LVI), and less frequent oestrogen receptor (ER) positivity in pandemic groups. No significant change was noted in BCS to mastectomy ratios, overall nodal positivity rates, or median tumour size. Conclusion Symptomatic breast cancers diagnosed since the onset of COVID-19 demonstrated an increase in new metastatic presentations and more aggressive histopathological characteristics when compared to a pre-pandemic control group. Rates of adjuvant radiotherapy and axillary surgery increased during the pandemic. Keywords Breast cancer · COVID-19 · Metastatic cancer · Pandemic · Symptomatic breast cancer · Tumour characteristics Introduction The first case of the COVID-19 virus was confirmed in Ireland on 26th February 2020 [1], with the first ensuing population-level lockdown ordered on 27th March 2020. No form of artificial intelligence was used to write the manuscript. * Áine Higgins [ainehiggins1999@gmail.com](ainehiggins1999@gmail.com) 1 Department of Breast Surgery, Cork University Hospital and University College Cork, Cork, Ireland 2 Department of Medical Oncology, College of Medicine and Health, Cork University Hospital and Cancer Research@ UCC, University College Cork, Cork, Ireland 3 Department of Breast Surgery, College of Medicine and Health, Cork University Hospital and Cancer Research@ UCC, University College Cork, Cork, Ireland Breast cancer services were disrupted at the onset of the pandemic due to the redeployment of staff and resources to care for COVID-19 patients, delays in elective diagnostic and surgical procedures, and staff shortages due to illness [2] . The pausing of BreastCheck, the Irish national breast screening programme, from March to October 2020 and January to March 2021 along with delays in symptomatic patients presenting to rapid access clinics due to fear of contracting the virus compounded the effect [3] . With symptomatic and screening services now restored to normal pre-pandemic activity, the longer-term impact of pandemic disruptions on Irish breast cancer patients is yet to be fully examined. Data from several countries have demonstrated reductions from expected rates of breast cancer diagnoses in 2020 along with delays in time to surgery from diagnosis [4–15] . Preliminary da

FAQs

What was the study’s main purpose?

To compare disease presentation and management for symptomatic breast cancer patients diagnosed before versus after the onset of COVID-19 in an Irish breast cancer unit.

How were patient groups defined in the retrospective cohort study?

2019 cases formed a pre-pandemic control group, while diagnoses from 2020, 2021, and 2022 formed the pandemic study groups.

What key change was observed in metastatic presentations?

New metastatic breast cancer presentations increased significantly in 2022 compared with 2019, while changes in 2020 and 2021 were not significant.

Did surgical approach and tumour size change during the pandemic period?

No significant change was noted in BCS-to-mastectomy ratios, overall nodal positivity rates, or median tumour size, even though tumour grade and other aggressive pathology markers increased.

Sep 21, 2026

Upload by Liam