4.7 Article

Prioritizing breast imaging services during the COVID pandemic: A survey of breast imaging facilities within the Breast Cancer Surveillance Consortium

Journal

PREVENTIVE MEDICINE
Volume 151, Issue -, Pages -

Publisher

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ypmed.2021.106540

Keywords

Breast cancer; COVID-19; Breast imaging; Preventive services; Mammography; Radiology; Screening; Diagnostic imaging; Healthcare delivery; Health services research

Funding

  1. Patient-Centered Outcomes Research Institute (PCORI) [PCS-1504-30370]
  2. National Cancer Institute [R01CA248068, P01CA154292]

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The COVID-19 pandemic disrupted breast cancer screening and diagnostic imaging services in the United States, with facilities mainly prioritizing diagnostic breast imaging over breast cancer screening during periods of reduced capacity or reopening. Factors including rescheduling canceled appointments, specific indication for diagnostic imaging, patient demand, individual characteristics and risk factors were commonly used to prioritize breast imaging services.
The COVID-19 pandemic disrupted breast cancer screening and diagnostic imaging in the United States. We sought to evaluate how medical facilities prioritized breast imaging services during periods of reduced capacity or upon re-opening after closures. In fall 2020, we surveyed 77 breast imaging facilities within the Breast Cancer Surveillance Consortium in the United States. The survey ascertained the pandemic's impact on clinical practices during March-September 2020. Nearly all facilities (97%) reported closing or operating at reduced capacity at some point during this period. All facilities were open by August 2020, though 14% were still operating at reduced capacity in September 2020. During periods of re-opening or reduced capacity, 93% of facilities reported prioritizing diagnostic breast imaging over breast cancer screening. For diagnostic imaging, facilities prioritized based on rescheduling canceled appointments (89%), specific indication for diagnostic imaging (89%), patient demand (84%), individual characteristics and risk factors (77%), and time since last imaging examination (72%). For screening mammography, facilities prioritized based on rescheduled cancelations (96%), patient demand (83%), individual characteristics and risk factors (73%), and time since last mammogram (71%). For biopsy services, more than 90% of facilities reported prioritization based on rescheduling of canceled exams, patient demand, patient characteristics and risk factors and level of suspicion on imaging. The observed patterns from this large and geographically diverse sample of facilities in the United States indicate that multiple factors were commonly used to prioritize breast imaging services during periods of reduced capacity.

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