Impact of the COVID-19 Pandemic on Breast Imaging: An Analysis of the National Mammography Database.
Impact of the COVID-19 Pandemic on Breast Imaging: An Analysis of the National Mammography Database.
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DOI：
10.1016/j.jacr.2022.04.008
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发表时间：
2022-08
影响因子：
4.5
通讯作者：
Zuley, Margarita L
中科院分区：
文献类型：
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作者：
Grimm, Lars J;Lee, Cindy;Rosenberg, Robert D;Burleson, Judy;Simanowith, Michael;Fruscello, Tom Jr;Pelzl, Casey E;Friedewald, Sarah M;Moy, Linda;Zuley, Margarita L
这项研究的目的是量化2019冠状病毒病（COVID-19）大流行期间乳腺癌筛查指标的初始下降和随后的反弹。从2019年3月1日至2021年5月31日的ACR国家乳腺X线摄影数据库中提取了筛查和诊断性乳腺X线摄影检查、活检和癌症诊断。收集患者（种族和年龄）和设施（区域位置，社区类型和设施类型）人口统计数据。三个时间段用于分析：COVID-19前（2019年3月1日至2019年5月31日）、COVID-19高峰期（2020年3月1日至2020年5月31日）及COVID-19恢复期（2021年3月1日至2021年5月31日）。在设施水平和各时间段之间进行总体分析。总共分析了5，633，783项筛查性乳房X线摄影研究、1，282，374项诊断性乳房X线摄影研究、231，390项活检和69，657项癌症诊断。所有COVID-19峰值指标均低于COVID-19前的量：筛查性乳腺X射线摄影为COVID-19前的36.3%，诊断性乳腺X射线摄影为57.9%，活检为47.3%，癌症诊断为48.7%。在COVID-19恢复期间，占COVID-19前的体积百分比出现了一些反弹：筛查性乳腺X射线摄影占COVID-19前的85. 3%，诊断性乳腺X射线摄影占97. 8%，活检占91. 5%，癌症诊断占92. 0%。在各种指标中，对老年妇女、亚洲妇女、东北地区的设施以及附属于学术医疗中心的设施的负面影响不成比例。2019冠状病毒病对筛查乳腺X射线摄影量的影响最大，其尚未恢复到2019冠状病毒病前的水平。癌症诊断在急性期显著下降，尚未完全反弹，强调需要增加针对特定患者群体和设施类型的外联工作。
The aim of this study was to quantify the initial decline and subsequent rebound in breast cancer screening metrics throughout the coronavirus disease 2019 (COVID-19) pandemic. Screening and diagnostic mammographic examinations, biopsies performed, and cancer diagnoses were extracted from the ACR National Mammography Database from March 1, 2019, through May 31, 2021. Patient (race and age) and facility (regional location, community type, and facility type) demographics were collected. Three time periods were used for analysis: pre-COVID-19 (March 1, 2019, to May 31, 2019), peak COVID-19 (March 1, 2020, to May 31, 2020), and COVID-19 recovery (March 1, 2021, to May 31, 2021). Analysis was performed at the facility level and overall between time periods. In total, 5,633,783 screening mammographic studies, 1,282,374 diagnostic mammographic studies, 231,390 biopsies, and 69,657 cancer diagnoses were analyzed. All peak COVID-19 metrics were less than pre-COVID-19 volumes: 36.3% of pre-COVID-19 for screening mammography, 57.9% for diagnostic mammography, 47.3% for biopsies, and 48.7% for cancer diagnoses. There was some rebound during COVID-19 recovery as a percentage of pre-COVID-19 volumes: 85.3% of pre-COVID-19 for screening mammography, 97.8% for diagnostic mammography, 91.5% for biopsies, and 92.0% for cancer diagnoses. Across various metrics, there was a disproportionate negative impact on older women, Asian women, facilities in the Northeast, and facilities affiliated with academic medical centers. COVID-19 had the greatest impact on screening mammography volumes, which have not returned to pre-COVID-19 levels. Cancer diagnoses declined significantly in the acute phase and have not fully rebounded, emphasizing the need to increase outreach efforts directed at specific patient population and facility types.