Impact of the COVID-19 pandemic on diagnostic breast biopsies: a retrospective comparative study

Aims: The purpose of this study is to evaluate and compare the quantity and pathological outcomes of diagnostic breast biopsy procedures performed in our interventional radiology unit before, during, and after the COVID-19 pandemic. This study aims to examine the influence of the COVID-19 pandemic on the quantity of biopsies performed and the rates of detecting malignancies during different time periods. Methods: This retrospective study examined 365 patients who underwent diagnostic breast biopsies between January 2019 and January 2023. The study was approved by the hospital's ethics committee. After excluding 19 patients with inconclusive pathology results, a total of 346 patients were analyzed. Biopsies were performed utilizing 14-18 G tru-cut needles with the assistance of ultrasound guidance. Patients were classified into the following periods: pre-pandemic, pandemic, and post-pandemic. The histopathological findings were categorized as either benign or malignant. Statistical comparisons were conducted using the SPSS software, and a significance level of p<0.05 was used. Results: The average age of the patients was 53.7 ± 15.7 years. Out of the total of 346 biopsies, 165 (47.7%) were determined to be malignant, while 177 (51.2%) were found to be benign. The distribution of biopsies was as follows: 76 (22.0%) were conducted before the pandemic, 13 (3.8%) were conducted during the pandemic, and 257 (74.3%) were conducted after the pandemic. There was a substantial decline in the number of biopsies during the pandemic compared to before the pandemic, and a significant rise in the post-pandemic period compared to both the pandemic and pre-pandemic periods (p=0.024 and p=0.041, respectively). The incidence of malignancies during the post-pandemic period was significantly greater compared to both the pre-pandemic period (p=0.045) and the pandemic period (p=0.027). Conclusion: The COVID-19 pandemic caused substantial disruptions in breast cancer diagnostics, as indicated by a decrease in the number of biopsies performed and delays in the detection of malignancies. Following the pandemic, there was a significant rise in the incidence of malignancies, which can be attributed to the delays in diagnosing and treating these conditions during the pandemic. These findings indicate the significance for stronger healthcare strategies to reduce the effects of future crises on cancer management.