METHODS: In this prospective cohort study, the QoL of 208 patients who underwent mastectomy and the BCS treatment were assessed, using the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire. The questionnaire was administered at the baseline, 6 and 12 months following diagnosis. One-way ANCOVA was used for statistical analysis.
RESULTS: A total of 208 female survivors of Stage 0-II breast cancer were included, among them 47.1% underwent BCS and 52.9% underwent mastectomy. Older (63.3%), Chinese women (63.6%), and patients with primary education (71.7%) were more likely to undergo mastectomy. At baseline, no significant differences were observed for QoL in both treatment groups. At 6 months, patients who underwent BCS had better social functioning scales( P = 0.006) and worse symptom scales for dyspnoea (P = 0.031), compared to mastectomy patients. One year after diagnosis, the role functioning score of the mastectomy group was significantly higher than the BCS group, specifically among patients who had undergone chemotherapy (P = 0.034).
CONCLUSION: Patients who underwent BCS had better social functioning and worse dyspnoea symptoms compared to patients undergoing mastectomy at six months. During one year, there were only significant improvements in the role functioning among the mastectomy groups compared to the BCS groups. After further stratification, only mastectomy patients who received chemotherapy exhibited improved role functioning compared to patients those who did not undergo chemotherapy. Providing social and physical support postoperatively and monitoring patients for cancer worry, or other symptoms in the long-term survivorship period would be important to ensure optimal QoL.
MATERIALS AND METHODS: Pre-COVID data were collected between January 1, 2019, to March 18, 2020, when a national lockdown was implemented, which caused the suspension of services at the breast clinic of University Malaya Medical Centre (UMMC). COVID data was obtained from March 2020 until June 2021.
RESULTS: This study compared 374 breast cancer patients in the COVID-19 period with 382 patients in the pre-COVID period. There was no significant difference in the median (range) time to surgery between pre-COVID [45 (26.50-153.50) days] and COVID [44 (24.75-156.25) days] periods. The clinicopathological features of breast cancer showed reduction in in situ carcinoma and increase in Stage 4 diagnoses during the COVID period. There was a reduction in screening-detected carcinoma (9% vs. 12.3%), mastectomy followed by immediate reconstruction (5.6% vs. 14.5%) and adjuvant chemotherapy (25.8% vs. 32.9%) in the COVID period.
CONCLUSION: In this center COVID-19 caused operational changes in breast cancer management, including a reduction in reconstructive procedures and adjuvant treatment. Healthcare disruption and fear of COVID may have caused delayed diagnosis, resulting in a higher frequency of Stage 4 disease and lower proportion of in situ carcinoma during the pandemic. However, there was no delay in the time to surgery, reduction in surgical volume, or change in surgery types.
METHODS: The video was developed using the BC delay explanatory model. A self-administered pre- and post-survey on 241 newly diagnosed BC patients in University Malaya Medical Center was performed. The Wilcoxon matched paired signed rank test was used to evaluate patients' pre and post perceived knowledge using a Likert scale 0 to 4 (0 = "no knowledge," 4 = "a great degree of knowledge"). Treatment adherence among participants were measured after 1-year follow-up.
RESULTS: Eighty percent of the patients reported that the video met or exceeded their expectations. In total 80.5% reported that the video was very effective and effective in improving their perspective on BC treatments. There was improvement in perceived knowledge for treatment options (mean scores; M = 0.93 versus M = 2.97) (p < 0.001) and also for perceived knowledge on types of operation, information on chemotherapy, radiotherapy, hormone therapy, healthy diet, physical activity after treatments, and care of the arm after operation(p < 0.001). In total 89.4%, 79.3%, and 85.9% adhered to surgical, chemotherapy, and radiotherapy recommended treatment, respectively.
CONCLUSION: The video improved patients' perceived knowledge and satisfaction. The program improved access not only to new BC patients but also the public and found sustainable using the YouTube platform.