COVID-19 pandemic resulted in more metastatic breast cancer cases at diagnosis

Abstract The study aimed to assess the impact of the COVID-19 pandemic on breast cancer diagnosis, tumor characteristics, and staging in an Eastern-European country. This retrospective study included 11,635 breast cancer patients and clients presenting between March 2019 and March 2022. Patients wer...

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Main Authors: Roxana Pintican, Maria Magdalena Duma, Agostino Matteo Spada, Madalina Szep, Dan Eniu, Angelica Chiorean
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-14582-z
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author Roxana Pintican
Maria Magdalena Duma
Agostino Matteo Spada
Madalina Szep
Dan Eniu
Angelica Chiorean
author_facet Roxana Pintican
Maria Magdalena Duma
Agostino Matteo Spada
Madalina Szep
Dan Eniu
Angelica Chiorean
author_sort Roxana Pintican
collection DOAJ
description Abstract The study aimed to assess the impact of the COVID-19 pandemic on breast cancer diagnosis, tumor characteristics, and staging in an Eastern-European country. This retrospective study included 11,635 breast cancer patients and clients presenting between March 2019 and March 2022. Patients were categorized into pre-pandemic, pandemic, and post-pandemic groups. Data included age, sex, pathology, tumor characteristics (histologic type, grade, ER/PR/HER2 status), and TNM staging. Statistical analysis compared these parameters across the three-time intervals.During the pandemic, breast cancer diagnosis decreased significantly compared to the pre-pandemic period (9.1% vs. 13.17%, p < 0.001) but increased post-pandemic (11%, p = 0.013). Invasive ductal carcinoma of non-special type (IDC-NST) was predominant in all three-time periods. Aggressive tumors (Nottingham grade 3, ER negative) increased during the pandemic and post-pandemic times. Molecular subtypes showed variations across time intervals, with triple-negative tumors rising significantly. Larger tumors, increased lymph node involvement (9–19%), and distant metastasis characterized the pandemic and post-pandemic periods. Compared to pre-pandemic patients, post-pandemic ones were 7 times more likely to be metastatic at diagnosis (p < 0.05). The COVID-19 pandemic led to a significant decrease in breast cancer diagnosis, particularly during the pandemic period. Tumors appeared more aggressive, with higher lymph node and distant metastatic involvement. The long-term prognosis and healthcare cost implications remain uncertain. These findings emphasize the need for adapted cancer screening programs and healthcare system readiness during pandemics.COVID-19 pandemic has resulted in a lower detection rate among patients diagnosed with breast cancer and increased TNM stage.
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spelling doaj-art-aa0b0fa6ff944d3e896ca3bb1ad4b4f92025-08-20T03:05:18ZengNature PortfolioScientific Reports2045-23222025-08-011511810.1038/s41598-025-14582-zCOVID-19 pandemic resulted in more metastatic breast cancer cases at diagnosisRoxana Pintican0Maria Magdalena Duma1Agostino Matteo Spada2Madalina Szep3Dan Eniu4Angelica Chiorean5Iuliu Hatieganu University of Medicine and PharmacyMedimages Breast CentreIuliu Hatieganu University of Medicine and PharmacyMedimages Breast CentreIuliu Hatieganu University of Medicine and PharmacyMedimages Breast CentreAbstract The study aimed to assess the impact of the COVID-19 pandemic on breast cancer diagnosis, tumor characteristics, and staging in an Eastern-European country. This retrospective study included 11,635 breast cancer patients and clients presenting between March 2019 and March 2022. Patients were categorized into pre-pandemic, pandemic, and post-pandemic groups. Data included age, sex, pathology, tumor characteristics (histologic type, grade, ER/PR/HER2 status), and TNM staging. Statistical analysis compared these parameters across the three-time intervals.During the pandemic, breast cancer diagnosis decreased significantly compared to the pre-pandemic period (9.1% vs. 13.17%, p < 0.001) but increased post-pandemic (11%, p = 0.013). Invasive ductal carcinoma of non-special type (IDC-NST) was predominant in all three-time periods. Aggressive tumors (Nottingham grade 3, ER negative) increased during the pandemic and post-pandemic times. Molecular subtypes showed variations across time intervals, with triple-negative tumors rising significantly. Larger tumors, increased lymph node involvement (9–19%), and distant metastasis characterized the pandemic and post-pandemic periods. Compared to pre-pandemic patients, post-pandemic ones were 7 times more likely to be metastatic at diagnosis (p < 0.05). The COVID-19 pandemic led to a significant decrease in breast cancer diagnosis, particularly during the pandemic period. Tumors appeared more aggressive, with higher lymph node and distant metastatic involvement. The long-term prognosis and healthcare cost implications remain uncertain. These findings emphasize the need for adapted cancer screening programs and healthcare system readiness during pandemics.COVID-19 pandemic has resulted in a lower detection rate among patients diagnosed with breast cancer and increased TNM stage.https://doi.org/10.1038/s41598-025-14582-zBreast cancerCOVIDTNM stage
spellingShingle Roxana Pintican
Maria Magdalena Duma
Agostino Matteo Spada
Madalina Szep
Dan Eniu
Angelica Chiorean
COVID-19 pandemic resulted in more metastatic breast cancer cases at diagnosis
Scientific Reports
Breast cancer
COVID
TNM stage
title COVID-19 pandemic resulted in more metastatic breast cancer cases at diagnosis
title_full COVID-19 pandemic resulted in more metastatic breast cancer cases at diagnosis
title_fullStr COVID-19 pandemic resulted in more metastatic breast cancer cases at diagnosis
title_full_unstemmed COVID-19 pandemic resulted in more metastatic breast cancer cases at diagnosis
title_short COVID-19 pandemic resulted in more metastatic breast cancer cases at diagnosis
title_sort covid 19 pandemic resulted in more metastatic breast cancer cases at diagnosis
topic Breast cancer
COVID
TNM stage
url https://doi.org/10.1038/s41598-025-14582-z
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