8th Baltic Congress of Radiology

Breast Radiology

oral abstract

The Covid-19 pandemic has had both direct impact on the population by causing an infection and indirect impact by causing limited healthcare services to those in need. Nationwide data shows that the response rate to breast cancer screening programme invitation was 39.1% in 2019 and then saw a sharp drop to 29.9% in 2020. This could result in a later diagnosis of breast cancer and worsen survival rate.

Data of 2910 women who had undergone “core” biopsy for suspicion of breast cancer between 2019 and 2021 were collected and analyzed in relationship with the epidemiological situation caused by Covid-19 pandemic in Latvia, 2020. All data on the performed “core” biopsies were compiled in a table dividing them by year and month and afterwards a line chart was drawn to better reflect obtained data. In addition, data on breast cancer stages in 2020 were collected and compared to the last available nationwide data from 2017 to analyze whether there might be an impact of the Covid-19 pandemic.

When March 2020 came with the Covid-19 pandemic, and invitation letters to breast cancer screening programme were not sent out, there was a sharp drop in “core” biopsy rate, that remained low until June. Comparing this period to the exact same in 2019, there was a 23% drop in diagnostic procedure rate. When the second Covid-19 pandemic wave came, from October to December, “ core” biopsy rate drop was 17%, compared to 2019, and remained low until February, 2021. At this time, breast cancer screening invitation letters were sent out and programme was running. However, if we compare 2020 data with 2019 in total there was a lower significance in rate drop, by only 6%. Comparing the stages of diagnosed breast cancer in 2020 at the Oncology Center of Latvia to nationwide data of breast cancer staged from 2017, there were no significant differences in the proportions of the stages. With stage I breast cancer 29.9% versus 30.7%, stage II 36% versus 36.8%, stage III 21.9% versus 18% and stage IV 7.3% in 2020 (Oncology Center of Latvia) versus 9.7% in 2017 (Nationwide data). And, if we compare these stage rates with the average breast cancer stage rates in Europe 2020, more frequently in Latvia breast cancer is diagnosed at stage III and stage IV.

The improvement in breast cancer survival is closely linked to effective screening programs and early diagnosis of symptomatic cases. Although the Covid-19 pandemic in 2020 did not affect Latvia as much when compared to other countries, there was still a decline in breast cancer diagnostic procedure rate. This could lead to a later diagnosis of the disease and thus later initiation of the treatment. The longer the duration of undetected breast cancer, the higher the risk that it will be in an advanced stage at the time of diagnosis. The European Society of Breast Imaging has released guidelines on how to divide patients in high, medium, and low priority, and in each priority how long can we delay diagnostic procedures, if necessary, because as the Covid-19 pandemic will be a challenge for some time we should prioritize and optimize breast cancer diagnostic procedures during the pandemic.

The Covid-19 pandemic has had both a direct impact on population and an indirect impact, by causing limited healthcare services. During the Covid-19 pandemic waves in 2020, there were significant falls in "core" biopsy rate seen, but overall "core" biopsy rate drop in 2020, compared to 2019, was only 6%. There were no significant data of the Covid-19 pandemic impact on breast cancer stages. Still, stage III and stage IV breast cancer rate in Latvia is notably higher than average rate in Europe.

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