A. L (Kochi/Cochin, India)
Amrita Institute of Medical SciencesAuthor Of 2 Presentations
154P - Impact Of Covid-19 On Diagnosis And Surgical Care Of Patients With Breast Cancer.
Abstract
Background
The COVID-19 pandemic took the attention of people in India when the first case was reported on January 30, 2020 and that was from Kerala. On March 21, 2020 lockdown was implemented throughout the country. When the pandemic accelerated, the routine health care system around the state was interrupted. The main aim of our study was to evaluate the effect of the COVID-19 pandemic on diagnosis and surgical care for patients with breast cancer in our institution.
Methods
This single-centre retrospective study was conducted to evaluate the effect of COVID-19 on the diagnosis and surgical care for patients with breast cancer before and after the pandemic. The data was collected from the electronic medical records of the hospital from March 2020- December 2020 and was compared with the data in the pre-pandemic time i.e., from March 2019- December 2019.
Results
2019 2020 P Value Mean age 54.96+/-13.065 53.20+/-11.944 0.261 Total mammograms 3689 1901 Total core biopsy 391 367 New patients 614 354 Total number of surgeries 318 287 Total no of bcs 127 93 .015 (statistically significant) Duration of symptoms (weeks) 20+/-56.38 15+/-24.3 0.188 Time taken for treatment (days) 25.05+/-52.12 days 31.52 +/- 44.44 days .306 Average tumour size 2.92+/-1.65 cm 2.91+/-1.31cm .963 Advanced stage *size > 5 cm *nact 23 24 25 37 .762 Duration of hospital stay 3.84+/- 1.485 days 3.97+/- 1.536 days .306 Total patients with complications 113 83 No of patients with post op infection 39 25 .186
Conclusions
The decrease in the number of new patients along with number of mammograms shows that there was a fall in number of patients visiting the hospital but core biopsy number and total number of surgeries being almost the same in both phases (mild decrease due to 1 month of total lockdown in April 2020) implies that the annual and routine check-ups might have been affected by the pandemic but those coming with suspicious masses which required a biopsy and surgery remained the same. This study shows that that there was no significant difference in the surgical care for patient with breast cancer before and after COVID-19. With proper clinical triaging and universal screening, continuation of cancer care is possible even during this pandemic.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
156P - The Effectiveness of Intraoperative Administration Of Both Radioactive Isotope And Blue Dye Without Pre-Surgery Gamma Imaging In Comparison With The Conventional Technique For Sentinel Node Biopsy.
Abstract
Background
Our departmental audit revealed some problems associated with the conventional technique of SLNB such as scheduling issues for OT, co-ordination issues and time lost in the process. Our analysis showed us that the sentinel node was always in axilla, appeared soon after injection, the injection was painful, and the location of the node did not influence the incision. We sat with our nuclear medicine colleagues and evolved a strategy to overcome these problems: Do away with the imaging under gamma camera; shift injection venue to the operating room, thus avoiding a lot of co-ordination and scheduling issues; avoid pain by injecting isotope after induction of general anaesthesia and; train persons to inject the radioactive material. This study is looking at 200 patients of SLN biopsy done by the conventional technique compared to the next 200 patients done with the dual technique.
Methods
Intraoperative dual SLN mapping consisted of subareolar injection of technetium 99m- labelled filtered sulphur colloid (15-37 MBq) and 2 ml of 1% iso sulfan blue dye just after anaesthetic induction. The conventional technique consisted of subareolar injection of radioactive colloid in Nuclear medicine followed by SPECT imaging and subareolar injection of blue dye intraoperatively. In both cases the SLN was detected using gamma probe and blue colour. SLN’s identified during these procedures were classified as “blue-hot” nodes, “hot-only” nodes, or “blue-only” nodes.
Results
Conventional technique Dual technique P value Total patients 202 238 Sentinel node detected 196 (97%) 232 (97.47%) 0.773 Hot and blue 159 (81.12%) 204 (87.9%) 0.054 Hot only 36 (18.36%) 25 (10.7%) 0.027 (significant) Blue only 1 (0.51%) 3 (1.29%) 0.399 SLN +VE, Other nodes -VE 32 24 0.070 Only non SLN +VE 6 2 0.096 SLN +VE, NON SLN + 12 15 0.875
Conclusions
SLN detection rate of dual technique was equivalent to conventional technique. Thereby, even in the absence of Nuclear medicine facility within the hospital, the SLNB can still be performed by procuring the radioactive colloid from a source at a distant site in the same town or city and using the hand-held gamma probe without affecting sensitivity or detection rates.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Presenter Of 1 Presentation
154P - Impact Of Covid-19 On Diagnosis And Surgical Care Of Patients With Breast Cancer.
Abstract
Background
The COVID-19 pandemic took the attention of people in India when the first case was reported on January 30, 2020 and that was from Kerala. On March 21, 2020 lockdown was implemented throughout the country. When the pandemic accelerated, the routine health care system around the state was interrupted. The main aim of our study was to evaluate the effect of the COVID-19 pandemic on diagnosis and surgical care for patients with breast cancer in our institution.
Methods
This single-centre retrospective study was conducted to evaluate the effect of COVID-19 on the diagnosis and surgical care for patients with breast cancer before and after the pandemic. The data was collected from the electronic medical records of the hospital from March 2020- December 2020 and was compared with the data in the pre-pandemic time i.e., from March 2019- December 2019.
Results
2019 2020 P Value Mean age 54.96+/-13.065 53.20+/-11.944 0.261 Total mammograms 3689 1901 Total core biopsy 391 367 New patients 614 354 Total number of surgeries 318 287 Total no of bcs 127 93 .015 (statistically significant) Duration of symptoms (weeks) 20+/-56.38 15+/-24.3 0.188 Time taken for treatment (days) 25.05+/-52.12 days 31.52 +/- 44.44 days .306 Average tumour size 2.92+/-1.65 cm 2.91+/-1.31cm .963 Advanced stage *size > 5 cm *nact 23 24 25 37 .762 Duration of hospital stay 3.84+/- 1.485 days 3.97+/- 1.536 days .306 Total patients with complications 113 83 No of patients with post op infection 39 25 .186
Conclusions
The decrease in the number of new patients along with number of mammograms shows that there was a fall in number of patients visiting the hospital but core biopsy number and total number of surgeries being almost the same in both phases (mild decrease due to 1 month of total lockdown in April 2020) implies that the annual and routine check-ups might have been affected by the pandemic but those coming with suspicious masses which required a biopsy and surgery remained the same. This study shows that that there was no significant difference in the surgical care for patient with breast cancer before and after COVID-19. With proper clinical triaging and universal screening, continuation of cancer care is possible even during this pandemic.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.